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Androgen and Cortisol Cosecreting Adrenal Adenoma and Tuberculous Lymphadenitis.
Garza-García, Gabriela; Sánchez-Villa, José Diego; Díaz-Trueba, Flavio Enrique; Lara-Salazar, Miguel Angel; Gómez-Pérez, Francisco Javier; Reza-Albarrán, Alfredo Adolfo.
Afiliação
  • Garza-García G; Department of Endocrinology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 Mexico City, Mexico.
  • Sánchez-Villa JD; Department of Endocrinology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 Mexico City, Mexico.
  • Díaz-Trueba FE; Department of Endocrine Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 Mexico City, Mexico.
  • Lara-Salazar MA; Department of Pathology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 Mexico City, Mexico.
  • Gómez-Pérez FJ; Department of Endocrinology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 Mexico City, Mexico.
  • Reza-Albarrán AA; Department of Endocrinology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 Mexico City, Mexico.
JCEM Case Rep ; 2(10): luae171, 2024 Oct.
Article em En | MEDLINE | ID: mdl-39324029
ABSTRACT
The differential diagnosis between malignant and benign adrenal cortical tumors is challenging, and concurrent androgen and cortisol production should raise  suspicion of a malignant tumor. We present the case of a 36-year-old woman who exhibited pronounced hirsutism, clitoromegaly, and secondary amenorrhea. A contrast-enhanced computed tomography (CT) scan revealed a 35 × 27 mm right adrenal mass with unenhanced CT attenuation of 40 Hounsfield units (HUs). The mass exhibited absolute and relative washout rates of 50% and 28%, respectively, and was accompanied by a 25 × 20 mm adenopathy located in the hepatogastric space. Total testosterone was elevated by 247 ng/dL (8.56 nmol/L) (normal reference range, 10-75 ng/dL; 0.34-2.6 nmol/L). A 1-mg dexamethasone suppression test revealed an elevated serum morning cortisol concentration of 10.57 µg/dL (291.58 nmol/L) (reference range, <1.8 µg/dL; < 49.66 nmol/L). A fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scan revealed increased uptake in both the adrenal mass and the adenopathy. Subsequently, the patient underwent an open right adrenalectomy and lymphadenectomy. Histological examination revealed the presence of an adrenal adenoma with myelolipomatous metaplasia, as well as a positive polymerase chain reaction (PCR) for Mycobacterium tuberculosis in the adenopathy.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: JCEM Case Rep Ano de publicação: 2024 Tipo de documento: Article País de afiliação: México País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: JCEM Case Rep Ano de publicação: 2024 Tipo de documento: Article País de afiliação: México País de publicação: Reino Unido