Cushing’s syndrome due to a left adrenal cortical carcinoma with metastasis to the liver and a massive vena cava tumor thrombus
Abstract
A 47-year-old woman with a seven-month history of increasing weight, hypertension and recently diagnosed diabetes presented features of hirsutism, frontal baldness, amenorrhea and hypokalemia.These characteristics were considered diagnostic of Cushing’s syndrome, and studies were initialized to identify its etiology. During hospitalization, the patient presented a torpid evolution resulting in death. Clinical autopsy revealed a 400 g carcinoma in the left adrenal gland, liver metastasis and a massivevena cava tumor thrombus which was the final cause of death.
doi: http://dx.doi.org/10.7705/biomedica.v32i4.568
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References
Contran R, Kumar V, CollinsT. Robbins: Patología estructural y funcional; 6a edición. Madrid: Mc Graw Hill; 2005. p. 1197-201.
Braunwald E, Fauci A, Kasper D, Hauser S, Longo D, Jameson L. Harrison: Principios de medicina interna. 17ª edición. Madrid: Mc Graw Hill; 2008. p. 2446-54.
Boscaro M, Arnaldi G. Approach to the patient with possible Cushing’s syndrome. J Clin Endocrinol Metab. 2009;94:3121-31. http://dx.doi.org/10.1210/jc.2009-0612
Dluhy R, Maher M, Wu C. Case 7-2005: A 59 year old woman with an incidentally discovered adrenal nodule. N Engl J Med. 2005;352:1025-32.
Hedican SP, Marshall FF. Adrenocortical carcinoma with intracaval extension. J Urol. 1997;158:2056-61. http://dx.doi.org/10.1016/S0022-5347(01)68152-7
Allolio B, Fassnacht M. Adrenocortical carcinoma. Clinical review. J Clin Endocrinol Metab. 2006;91:2027-37. http://dx.doi.org/10.1210/jc.2005-2639
Reincke M, Karl M, Travis W. P53 mutations in human adrenocortical neoplasms: Immunohistochemical and molecular studies. J Clin Endocrinol Metab. 1994;78:790-4.http://dx.doi.org/10.1210/jc.78.3.790
Del Gaudio AD, Del Gaudio GA. Virilizing adrenocortical tumors in an adult woman. Report of 10 patients, 2 of whom each had a tumor secreting only testosterone. Cancer. 1993;72:1997-2003.
Wooten M, King D. Adrenal cortical carcinoma. Epidemiology and treatment with mitotane and a review of the literature. Cancer. 1993;72:3145-55.
Vassilopoulou-Sellin R, Schultz P. Adrenocortical carcinoma. Clinical outcome at the end of the 20th century. Cancer. 2001;92:1113-21.
Crucitti F, Bellantone R, Ferrante A, Bischerini M, Crucitti P. The Italian registry for adrenal cortical carcinoma: Analysis of a multiinstitutional series of 129 patients. The ACC Italian registry study group. Surgery. 1996;119:161-70.
Castleman B, Scully R, McNeely B. Case records of the Massachusetts General Hospital. Case 46-1972. N Engl J Med. 1972;287:1033-40.
Golub RM, Parsons RE, Sigel B, Barnes AU. A review of venous collaterals in inferior vena cava obstruction. Clinical Anatomy. 1992;5:441-51. http://dx.doi.org/10.1002/ca.980050604
Shahian DM, Nieh PT, Libertino JA. Resection of atriocaval carcinoma using hypothermic circulatory arrest. Ann Thorac Surg. 1989;48:421-2. http://dx.doi.org/10.1016/S0003-4975(10) 62870-6
Bower T, Nagorney D, Toomey B, Gloviczki P, Pairolero P, Hallett J. Vena cava replacement for malignant disease: Is there a role? Ann Vasc Surg. 1993;7:51-62. http://dx.doi.org/10.1007/BF02042660
Eilber F, Gelabert H, Quinones-Baldrich W. Prosthetic replacement of the inferior vena cava for malignancy. J Vasc Surg. 1998;28:75-83.
Smith B, Mulherin J, Sawyers J, Turner B, Prager R, Dean R. Suprarenal vena caval occlusion. Principles of operative management. Ann Surg. 1984;199:656-67.
Roizen M. Anesthetic implications of concurrent diseases. Adrenocortical malfunction. 4th edition. New York: Churchill Livingstone; 1994. p. 917-8.
Icard P, Goudet P, Charpenay C. Adrenocortical carcinoma: Surgical trends and results of a 253-patient series from the French Association of Endocrine Surgeons Study Group. World J Surg. 2001;25:891-7. http://dx.doi.org/10.1007/s00268-001-0047-y
Chiche L, Dousset B, Kieffer E, Chapuis Y. Adrenocortical carcinoma extending into the inferior vena cava: Presentation of a 15-patient series and review of the literature. Surgery. 2006;139:15-27. http://dx.doi.org/10.1016/j.surg.2005. 05.014
Song J, Chaudry F, Mayo-Smith W. The incidental adrenal mass on CT: Prevalence of adrenal disease in 1,049 consecutive adrenal masses in patients with no known malignancy. AJR Am J Roentgenol. 2008;190:1163-8. http://dx.doi.org/10.2214/AJR.07.2799
Mansmann G, Lau J, Balk E, Rothberg M, Miyachi Y, Bornstein S. The clinically inapparent adrenal mass: Update in the diagnosis and management. Endocr Rev. 2004;25:309-40. http://dx.doi.org/10.1210/er.2002-0031
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