Goyal Ashutosh, Panchani Roopal, Varma Tarun, Bhalla Sunita, Tripathi Sudhir
Department of Endocrinology, Sir Ganga Ram Hospital, New Delhi, India.
Indian J Endocrinol Metab. 2013 Oct;17(Suppl 1):S246-8. doi: 10.4103/2230-8210.119587.
Adrenal incidentalomas (AIs) are a cluster of different pathologies, but AIs with dual functional aspects are very rare. We report a case of AI with the evidence of both pheochromocytoma and sub-clinical Cushing's syndrome. A 42-year-old female patient presented with the history of abdominal pain. Abdominal computed tomography revealed right adrenal mass suggestive of pheochromocytoma. On endocrine evaluation, she admitted history of intermittent headache and palpitations for 4 years and was on treatment for hypertension and diabetes. There were no signs and symptoms suggestive of Cushing's syndrome. The laboratory data demonstrated 10 times raised 24-h urinary fractionated metanephrines with non-suppressible serum cortisol after 2-day low-dose dexamethasone suppression test. She underwent right-sided adrenalectomy with subsequent resolution of both pheochromocytoma and hypercortisolism. Patient was discharged in good clinical condition.
肾上腺偶发瘤（AIs）是一组不同的病理情况，但具有双重功能表现的肾上腺偶发瘤非常罕见。我们报告一例肾上腺偶发瘤，该病例同时存在嗜铬细胞瘤和亚临床库欣综合征的证据。一名42岁女性患者因腹痛就诊。腹部计算机断层扫描显示右肾上腺肿块，提示嗜铬细胞瘤。在内分泌评估中，她承认有4年间歇性头痛和心悸病史，正在接受高血压和糖尿病治疗。没有库欣综合征的体征和症状。实验室数据显示，24小时尿分馏甲氧基肾上腺素升高10倍，且在进行为期2天的小剂量地塞米松抑制试验后，血清皮质醇不可抑制。她接受了右侧肾上腺切除术，随后嗜铬细胞瘤和皮质醇增多症均得到缓解。患者出院时临床状况良好。
