Abstract #125: Oncocytic Adrenal Tumor Presenting as Cushing’s Syndrome-Rare Presentation of a Rare Tumor

2015 ◽  
Vol 21 ◽  
pp. 14
Author(s):  
Subodh Banzal ◽  
Sonal Banzal ◽  
Abhishek Singhai
Keyword(s):  
Cushing’S Syndrome ◽  
Adrenal Tumor ◽  
Cushing's Syndrome ◽  
Rare Tumor ◽  
Rare Presentation

scholarly journals Dexmedetomidine for Conscious Sedation in Bilateral Inferior Petrosal Sinus Sampling

2016 ◽  
Vol 1 (2) ◽  
pp. 61-62
Author(s):  
Neeraj Barnwal ◽  
Raylene Dias ◽  
Rahul Mamde
Keyword(s):  
General Anesthesia ◽  
Cushing’S Syndrome ◽  
Conscious Sedation ◽  
Cushing's Syndrome ◽  
Inferior Petrosal Sinus ◽  
The Novel ◽  
Rare Presentation ◽  
Inferior Petrosal Sinus Sampling ◽  
Ectopic Adrenocorticotropic Hormone ◽  
Acth Secreting

ABSTRACT Cushing's syndrome in an acromegalic patient is a very rare presentation. To differentiate a Cushing's disease from Cushing's syndrome due to ectopic adrenocorticotropic hormone (ACTH) secreting tumors, inferior petrosal sinus sampling (IPSS) is required. Acromegaly patients have associated airway abnormalities posing a challenge to administration of anesthesia. Traditionally, most IPSS was done under general anesthesia. But now it is being recognized that general anesthesia for this procedure has its own implications and hence conscious sedation is being used for this purpose. We describe our experience with the novel agent dexmedetomidine for conscious sedation in this procedure. How to cite this article Barnwal N, Dias R, Mamde R. Dexmedetomidine for Conscious Sedation in Bilateral Inferior Petrosal Sinus Sampling. Res Inno in Anesth 2016;1(2):61-62.

CUSHING'S SYNDROME IN INFANCY

PEDIATRICS ◽  
1970 ◽  
Vol 46 (2) ◽  
pp. 217-229
Author(s):  
Michel G. Gilbert ◽  
William W. Cleveland
Keyword(s):  
Surgical Treatment ◽  
Cushing’S Syndrome ◽  
Adrenal Tumor ◽  
Cushing's Syndrome ◽  
Adrenal Steroids ◽  
Careful Attention ◽  
Intravenous Pyelogram ◽  
Reasonable Expectation ◽  
Surgical Cure ◽  
Postoperative Administration

Cushing's syndrome in infancy is usually due to adrenal tumor which is often malignant. Three cases are described in which the disorder was due to adenoma and surgical cure was achieved. The clinical picture is strongly suggestive if not diagnostic. Its hallmark is generalized obesity with typical facies; also present are hypertension and signs of virilization. Striae were not found in our patients. Increased excretion of both 17-hydroxysteroids and 17-ketosteroids is characteristic; this excretion was not suppressed by dexamethasone in two of these patients in whom it was tested. Intravenous pyelogram was distinctly abnormal in all cases and indicated the presence and location of the tumor. The diagnosis can be made efficiently and surgical treatment can be promptly instituted with reasonable expectation of cure. Careful attention must be paid to preoperative and postoperative administration of adrenal steroids.

Presence of a Gsα mutation in an adrenal tumor expressing LH/hCG receptors and clinically associated with Cushing's syndrome

2000 ◽  
Vol 14 (1) ◽  
pp. 50-54 ◽  
Author(s):  
M. J. M. Bugalho ◽  
X. Li ◽  
Ch. V. Rao ◽  
J. Soares ◽  
L. G. Sobrinho
Keyword(s):  
Cushing’S Syndrome ◽  
Adrenal Tumor ◽  
Cushing's Syndrome ◽  
Gsα Mutation

scholarly journals RECOGNIZING ENDOGENOUS CUSHING’S SYNDROME AFTER THERAPY FOR SCLERODERMA

2016 ◽  
Vol 63 (4) ◽  
pp. 334-337
Author(s):  
Ana Valea ◽  
◽  
Dan Nicolae Paduraru ◽  
Adriana Elena Nica ◽  
Maria Iuliana Oprisor ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Adrenal Tumor ◽  
White Blood Cells ◽  
Serum Cortisol ◽  
Cushing's Syndrome ◽  
Serum Cortisol Level ◽  
Adrenal Crisis ◽  
Metabolic Disturbances ◽  
Threatening Condition ◽  
The Moment

Introduction. Scleroderma induces heterogeneous skin changes due to collagen anomalies, including facial. The recommended therapy is, among others, topic cortisol derived products, so an issue of diagnosis differential regarding the etiological type of Cushing’s syndrome (CS) is raised if a patient develops a suggestive phenotype. Case presentation. This is a 64-year female presenting (since the last few months) red face, high blood pressure, central obesity. She has a 6-year history of scleroderma, intermittently treated with local corticotherapy. On admission, she associated metabolic disturbances as lipid profile anomalies, high uric acid, insulin resistance and increased number of white blood cells (which were not connected with a relapse of scleroderma, neither to an inflammatory syndrome). Low baseline plasma ACTH and morning serum cortisol level (not high, yet detectable) with abnormal diurnal rhythm suggested an adrenal source of CS. A 3 cm right adrenal tumor was found on computer tomography and later removed through a classical intervention. Two weeks after, the patient voluntarily reduced her prednisone dose causing an adrenal crisis which required re-admission as an emergency. After discharge, daily oral adrenal replacement therapy is needed for the moment. Conclusions. Scleroderma, especially with skin involvement, and some of associated therapies may mask an endogenous CS as adrenal tumor derivate, thus delaying the adequate diagnosis and therapy. Patient’s education regarding a potential life threatening condition as chronic adrenal insufficiency is necessary since post-operatory recovery of adrenal function is expected within 6 to 24 months.

Cushing's syndrome caused by mixed adrenal tumor of cortical origin associated with myelolipoma

2017 ◽  
Vol 148 (6) ◽  
pp. 285-286
Author(s):  
Andreu Simó-Servat ◽  
Manuel Pérez Maraver ◽  
Jordi Caballero Corchuelo
Keyword(s):  
Cushing’S Syndrome ◽  
Adrenal Tumor ◽  
Cushing's Syndrome

scholarly journals Adrenal Cushing’s syndrome during pregnancy

2017 ◽  
Vol 177 (5) ◽  
pp. K13-K20 ◽  
Author(s):  
C E Andreescu ◽  
R A Alwani ◽  
J Hofland ◽  
L H J Looijenga ◽  
W W de Herder ◽  
...  
Keyword(s):  
Luteinizing Hormone ◽  
Cushing’S Syndrome ◽  
Adrenal Tumor ◽  
Cushing Syndrome ◽  
Adrenal Adenoma ◽  
Cushing's Syndrome ◽  
Receptor Expression ◽  
Aberrant Expression ◽  
Cortisol Responses

Cushing syndrome (CS) during pregnancy is a rare condition with only a few cases reported in the literature. Misdiagnosis of CS is common because of overlapping features like fatigue, weight gain, striae and emotional changes that can occur during normal pregnancy. Changes in maternal hormones and their binding proteins complicate assessment of glucocorticoid hormone levels during gestation. CS during pregnancy is most frequently due to an adrenal adenoma and to a lesser degree to adrenocorticotropic hormone (ACTH) hypersecretion by a pituitary adenoma. Furthermore, aberrant expression of luteinizing hormone (LH) receptors in the adrenal cortex has been suggested to be involved in the pathogenesis of adrenal CS during pregnancy. We report three pregnant women with ACTH-independent Cushing’s syndrome and an adrenal tumor. After uncomplicated delivery, patient 1 underwent in vivo testing for aberrant hormone receptor expression by the adenoma. Cortisol responses were found after administration of luteinizing hormone-releasing hormone (LHRH), human chorionic gonadotropin (hCG), glucagon, vasopressin and a standard mixed meal. All patients were treated with laparoscopic adrenalectomy. Adrenal tumor tissue of two patients showed positive immunohistochemical staining of LH receptors. Considering the cortisol responses to LHRH and hCG, and the development of CS during pregnancy in these patients, it is likely that ACTH-independent hypercortisolism was induced by the pregnancy-associated rise in hCG levels that activated aberrantly expressed LH receptors in the adrenal adenoma. Remarkably, adrenal adenomas may simultaneously express multiple aberrant receptors and individual ligands may play a role in the regulation of cortisol production in CS during pregnancy.

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