CLINICAL AND ENDOCRINOLOGICAL FEATURES OF ADRENOCORTICOTROPIC HORMONE- INDEPENDENT BILATERAL MACRONODULAR ADRENOCORTICAL HYPERPLASIA
2001; Lippincott Williams & Wilkins; Volume: 166; Issue: 5 Linguagem: Inglês
10.1016/s0022-5347(05)65643-1
ISSN1527-3792
AutoresHirokazu Shinojima, Hidehiro Κakizaki, Tomoaki Usuki, Toru Harabayashi, Kaname Ameda, Tomohiko Koyanagi,
Tópico(s)Neurofibromatosis and Schwannoma Cases
ResumoNo AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Nov 2001CLINICAL AND ENDOCRINOLOGICAL FEATURES OF ADRENOCORTICOTROPIC HORMONE- INDEPENDENT BILATERAL MACRONODULAR ADRENOCORTICAL HYPERPLASIA HIROKAZU SHINOJIMA, HIDEHIRO KAKIZAKI, TOMOAKI USUKI, TORU HARABAYASHI, KANAME AMEDA, and TOMOHIKO KOYANAGI HIROKAZU SHINOJIMAHIROKAZU SHINOJIMA More articles by this author , HIDEHIRO KAKIZAKIHIDEHIRO KAKIZAKI More articles by this author , TOMOAKI USUKITOMOAKI USUKI More articles by this author , TORU HARABAYASHITORU HARABAYASHI More articles by this author , KANAME AMEDAKANAME AMEDA More articles by this author , and TOMOHIKO KOYANAGITOMOHIKO KOYANAGI More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)65643-1AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We report clinical findings in 5 patients with adrenocorticotropic hormone independent bilateral macronodular adrenocortical hyperplasia. Materials and Methods: In 4 males and 1 female 32 to 61 years old (median age 50) we evaluated clinical symptoms, endocrinological and radiological characteristics, treatment modality and postoperative clinical course. Results: All cases presented with some features of Cushing’s syndrome. Endocrinological examination revealed autonomous adrenal cortisol production with suppressed adrenocorticotropic hormone and a loss in the diurnal circadian rhythm of plasma cortisol. Abdominal computerized tomography showed bilateral enlargement of the adrenal glands with multiple nodules. 131Iodine labeled adosterol scintigraphy demonstrated remarkable bilateral uptake by the adrenal glands. The pituitary gland appeared normal on magnetic resonance imaging. Open unilateral complete adrenalectomy and contralateral partial adrenalectomy were performed in patient 1, open bilateral complete adrenalectomy was done in patients 2 and 3, and 2 and 1-stage laparoscopic bilateral complete adrenalectomy was performed in patients 4 and 5. Single removed adrenal glands weighed 32 to 108 gm. (median 60). The histological diagnosis was macronodular adrenocortical hyperplasia in all cases. Postoperative followup was 3 to 90 months. Clinical symptoms of Cushing’s syndrome disappeared or improved after surgery in all cases. Conclusions: Although adrenocorticotropic hormone independent bilateral macronodular adrenocortical hyperplasia is a rare form of Cushing’s syndrome, physicians are advised to consider it when diagnosing and treating cases of Cushing’s syndrome with enlarged bilateral adrenal glands. Bilateral complete adrenalectomy is currently recommended as the treatment of choice. 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Google Scholar From the Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 166Issue 5November 2001Page: 1639-1642 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordsadrenalectomycorticotropindiagnosis, differentialadrenal glandsCushing syndromeMetrics Author Information HIROKAZU SHINOJIMA More articles by this author HIDEHIRO KAKIZAKI More articles by this author TOMOAKI USUKI More articles by this author TORU HARABAYASHI More articles by this author KANAME AMEDA More articles by this author TOMOHIKO KOYANAGI More articles by this author Expand All Advertisement PDF downloadLoading ...
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