Aldosterone-Producing Adrenocortical Carcinoma with Co-Secretion of Cortisol and Estradiol: A Case Report

Lazaro, Karen; Adorable-Wagan, Perie

doi:10.15605/jafes.033.01.10

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…Based on the available case reports, dual- or triple-secreting ACC cases present as a mix of both overt Cushing syndrome [ 3 , 4 , 6 ] and MACS (defined as morning cortisol after 1 mg dexamethasone suppression test greater than 1.8 µg/dL without overt signs of Cushing syndrome) [ 5 ]. No data are available as whether the presence of multiple hormonal secretion syndromes affects the likelihood of malignancy.…”

Section: Discussionmentioning

confidence: 99%

“…ACC presentation with a combination of hormonal excess syndromes from different adrenal zones is rare and described previously only in 4 case reports [ 3-6 ]. Patients presented either with biochemical evidence of combined aldosterone and cortisol hypersecretion [ 5 , 6 ], aldosterone, cortisol, and estradiol excess [ 4 ], or aldosterone, cortisol, and androgen excess [ 3 ]. Given the rarity of co-secreting tumors, the impact on morbidity or mortality compared to single-hormone-secreting ACC is unknown.…”

Section: Introductionmentioning

confidence: 99%

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Dual Aldosterone- and Cortisol-Secreting Adrenal Cortical Carcinoma: Pre- and Perioperative Evaluation and Management

et al. 2023

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Adrenal cortical carcinoma (ACC) is a rare cancer (1-2/million) that presents with hormone overproduction in 60% of cases. Presentation of ACC with multiple hormone syndromes from different adrenal zones is rare. We present a case of dual-secreting ACC with hyperaldosteronism and cortisol excess. The previously healthy patient was noted to have new-onset hypertension and hypokalemia during a primary care visit. On hormonal evaluation, he was found to have evidence of hyperaldosteronism and adrenocorticotropic hormone (ACTH)-independent cortisol excess. Imaging revealed a 2.7 × 3.1 × 3.5 cm left adrenal mass with indeterminant computed tomography characteristics. He underwent laparoscopic adrenalectomy and required glucocorticoid replacement for adrenal insufficiency postoperatively. Pathology revealed stage T2N0M0 ACC. His hypokalemia resolved and glucocorticoids were stopped within a month. This case stresses the importance of routine screening for cortisol excess in all adrenal masses detected on imaging. Avoidance of postoperative adrenal insufficiency in patients with cortisol excess without overt Cushing syndrome is paramount.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dual Aldosterone- and Cortisol-Secreting Adrenal Cortical Carcinoma: Pre- and Perioperative Evaluation and Management

et al. 2023

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“…En cas de récidive où l'exérèse a été incomplète ou récusée, le traitement de première ligne est le mitotane. Le traitement par mitotane doit être adapté au taux sérique qui doit être supérieur à 14 μg/ml pour atteindre une dose thérapeutique efficace [ 14 ]. Le mitotanne associé à la chimiothérapie est plus efficace que le mitotane seul.…”

Section: Discussionunclassified

Le corticosurrénalome: une cause exceptionnelle d’hyperaldostéronisme primaire

Zantour¹,

Charrada²,

Elati³

et al. 2018

Pan Afr Med J

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Le corticosurrénalome est une tumeur maligne rare de la cortico-surrénale. Il secrète souvent des corticostéroïdes, des stéroïdes sexuels et des précurseurs. Le corticosurrénalome producteur d'aldostérone est très rare, 1cas/10 millions d'habitants. Nous rapportons l'observation d'un homme de 38 ans se présentant pour hypertension artérielle sévère associée à une hypokaliémie profonde (2.2 mmol/l). L'exploration a conclu à un hyperaldostéronisme primaire (aldostérone = 2645pmol/l, rapport aldostérone/rénine = 327pmol/mUI), avec hypersécrétion de glucocorticoïdes. Le scanner abdomino-pelvien a montré une masse surrénalienne gauche de 9cm, mal limitée et hétérogène, infiltrant la graisse autour et le diaphragme, envahissant la veine rénale gauche, avec adénopathie régionale et nodule hépatique de 4 cm. Le patient a eu une néphrectomie élargie, suivie d'une hépatectomie droite deux mois après entrainant une rémission. Un an après le patient a développé des métastases pulmonaires. Nous concluons que l'hyperaldostéronisme primaire peut être un mode de révélation du corticosurrénalome, on devra y penser malgré son caractère exceptionnel.

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Potassium losing, aldosterone producing adrenocortical carcinoma: a rare presentation

et al. 2020

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Adrenocortical carcinomas (ACCs) are rare malignancies with an incidence of one to two per million per year. Aldosterone-producing ACCs (APACs) are extremely rare with an incidence less than 1%. We describe a rare case of APAC, presenting with episodic lower-limb weakness and hypertension. Our patient was found to have serum aldosterone levels of 20.8 ng/dL (2.5–15.2) with persistent hypokalaemia and a 9.7×8.3×7.7 cm right adrenal mass, which was suspicious of malignancy on evaluation. He underwent a complete surgical resection which confirmed the diagnosis of ACC and normalised his aldosterone and potassium levels. He was then subjected to postoperative chemotherapy. Postoperative adjuvant chemotherapy with mitotane has a role in preventing recurrence.

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Aldosterone-Producing Adrenocortical Carcinoma with Co-Secretion of Cortisol and Estradiol: A Case Report

Cited by 3 publications

References 8 publications

Dual Aldosterone- and Cortisol-Secreting Adrenal Cortical Carcinoma: Pre- and Perioperative Evaluation and Management

Dual Aldosterone- and Cortisol-Secreting Adrenal Cortical Carcinoma: Pre- and Perioperative Evaluation and Management

Le corticosurrénalome: une cause exceptionnelle d’hyperaldostéronisme primaire

Potassium losing, aldosterone producing adrenocortical carcinoma: a rare presentation

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