Endogenous Cushing’s Syndrome with Precocious Puberty in an 8-Year-Old Boy due to a Large Unilateral Adrenal Adenoma
Adrenocortical tumors (ACTs) causing Cushing’s syndrome are extremely rare in children and adolescents. Bilateral macronodular adrenocortical disease which is a component of the McCune-Albright syndrome is the most common cause of endogenous Cushing’s syndrome. We report the case of a boy with Cushi...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2013-01-01
|
| Series: | Case Reports in Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2013/706989 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832549970282020864 |
|---|---|
| author | Muhammad Rajib Hossain Md. Mashiul Alam Junaid Nabi Mahzabin Kibria |
| author_facet | Muhammad Rajib Hossain Md. Mashiul Alam Junaid Nabi Mahzabin Kibria |
| author_sort | Muhammad Rajib Hossain |
| collection | DOAJ |
| description | Adrenocortical tumors (ACTs) causing Cushing’s syndrome are extremely rare in children and adolescents. Bilateral macronodular adrenocortical disease which is a component of the McCune-Albright syndrome is the most common cause of endogenous Cushing’s syndrome. We report the case of a boy with Cushing’s syndrome who presented with obesity and growth retardation. The child was hypertensive. The biochemical evaluation revealed that his serum cortisol levels were 25.80 g/dL, with a concomitant plasma ACTH level of 10.0 pg/mL and nonsuppressed serum cortisol on high-dose dexamethasone suppression test (HDDST) to be 20.38 g/dL. Computed tomography of the abdomen demonstrated a 8 × 6 × 5 cm left adrenal mass with internal calcifications. Following preoperative stabilization, laparotomy was carried out which revealed a lobulated left adrenal mass with intact capsule weighing 120 grams. Histopathological examination revealed a benign cortical neoplastic lesion, suggestive of adrenal adenoma; composed of large polygonal cells with centrally placed nuclei and prominent nucleoli without capsular and vascular invasion. On the seventh postoperative day, cortisol levels were within normal range indicating biochemical remission of Cushing’s syndrome. On followup after three months, the patient showed significant clinical improvement and had lost moderate amount of weight and adrenal imaging was found to be normal. |
| format | Article |
| id | doaj-art-f7ef914cc2ae44d390008bdb8434fc47 |
| institution | Kabale University |
| issn | 2090-6501 2090-651X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Endocrinology |
| spelling | doaj-art-f7ef914cc2ae44d390008bdb8434fc472025-02-03T06:08:12ZengWileyCase Reports in Endocrinology2090-65012090-651X2013-01-01201310.1155/2013/706989706989Endogenous Cushing’s Syndrome with Precocious Puberty in an 8-Year-Old Boy due to a Large Unilateral Adrenal AdenomaMuhammad Rajib Hossain0Md. Mashiul Alam1Junaid Nabi2Mahzabin Kibria3Department of Medicine, Shaheed Suhrawardy Medical College Hospital, Sher-e-Bangla Nagar, Dhaka 1207, BangladeshDepartment of Pediatrics, Dhaka Medical College Hospital, 100 Ramna, Dhaka 1000, BangladeshDepartment of Surgery, Shaheed Suhrawardy Medical College Hospital, Sher-e-Bangla Nagar, Dhaka 1207, BangladeshDepartment of Medicine, Shaheed Suhrawardy Medical College Hospital, Sher-e-Bangla Nagar, Dhaka 1207, BangladeshAdrenocortical tumors (ACTs) causing Cushing’s syndrome are extremely rare in children and adolescents. Bilateral macronodular adrenocortical disease which is a component of the McCune-Albright syndrome is the most common cause of endogenous Cushing’s syndrome. We report the case of a boy with Cushing’s syndrome who presented with obesity and growth retardation. The child was hypertensive. The biochemical evaluation revealed that his serum cortisol levels were 25.80 g/dL, with a concomitant plasma ACTH level of 10.0 pg/mL and nonsuppressed serum cortisol on high-dose dexamethasone suppression test (HDDST) to be 20.38 g/dL. Computed tomography of the abdomen demonstrated a 8 × 6 × 5 cm left adrenal mass with internal calcifications. Following preoperative stabilization, laparotomy was carried out which revealed a lobulated left adrenal mass with intact capsule weighing 120 grams. Histopathological examination revealed a benign cortical neoplastic lesion, suggestive of adrenal adenoma; composed of large polygonal cells with centrally placed nuclei and prominent nucleoli without capsular and vascular invasion. On the seventh postoperative day, cortisol levels were within normal range indicating biochemical remission of Cushing’s syndrome. On followup after three months, the patient showed significant clinical improvement and had lost moderate amount of weight and adrenal imaging was found to be normal.http://dx.doi.org/10.1155/2013/706989 |
| spellingShingle | Muhammad Rajib Hossain Md. Mashiul Alam Junaid Nabi Mahzabin Kibria Endogenous Cushing’s Syndrome with Precocious Puberty in an 8-Year-Old Boy due to a Large Unilateral Adrenal Adenoma Case Reports in Endocrinology |
| title | Endogenous Cushing’s Syndrome with Precocious Puberty in an 8-Year-Old Boy due to a Large Unilateral Adrenal Adenoma |
| title_full | Endogenous Cushing’s Syndrome with Precocious Puberty in an 8-Year-Old Boy due to a Large Unilateral Adrenal Adenoma |
| title_fullStr | Endogenous Cushing’s Syndrome with Precocious Puberty in an 8-Year-Old Boy due to a Large Unilateral Adrenal Adenoma |
| title_full_unstemmed | Endogenous Cushing’s Syndrome with Precocious Puberty in an 8-Year-Old Boy due to a Large Unilateral Adrenal Adenoma |
| title_short | Endogenous Cushing’s Syndrome with Precocious Puberty in an 8-Year-Old Boy due to a Large Unilateral Adrenal Adenoma |
| title_sort | endogenous cushing s syndrome with precocious puberty in an 8 year old boy due to a large unilateral adrenal adenoma |
| url | http://dx.doi.org/10.1155/2013/706989 |
| work_keys_str_mv | AT muhammadrajibhossain endogenouscushingssyndromewithprecociouspubertyinan8yearoldboyduetoalargeunilateraladrenaladenoma AT mdmashiulalam endogenouscushingssyndromewithprecociouspubertyinan8yearoldboyduetoalargeunilateraladrenaladenoma AT junaidnabi endogenouscushingssyndromewithprecociouspubertyinan8yearoldboyduetoalargeunilateraladrenaladenoma AT mahzabinkibria endogenouscushingssyndromewithprecociouspubertyinan8yearoldboyduetoalargeunilateraladrenaladenoma |