Open AccessAldosterone and cortisol co-secreting bifunctional adrenal cortical carcinoma: A rare event
Author(s) -
Puskar Shyam Chowdhury,
Prasant Nayak,
Srinivasan Gurumurthy,
Deepak David
Publication year - 2014
Publication title -
indian journal of urology/indian journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.333
H-Index - 30
eISSN - 1998-3824
pISSN - 0970-1591
DOI - 10.4103/0970-1591.134248
Subject(s) - hyperaldosteronism , medicine , aldosterone , adrenocortical carcinoma , hypokalemia , endocrinology , adrenalectomy , hydrocortisone , urology
Adrenocortical carcinoma (ACC) co-secreting aldosterone and cortisol is extremely rare. We report the case of a 37-yearold female who presented with paresis and facial puffiness. Evaluation revealed hypertension, hyperglycemia, severe hypokalemia and hyperaldosteronemia with elevated plasma aldosterone to renin ratio (ARR). Urinary free cortisol estimation showed elevated levels. Computed tomography scan revealed a right adrenal mass. Radical adrenalectomy specimen revealed ACC (T3N1). Post-operatively, the patient became normotensive and euglycemic with normalization of urinary cortisol and ARR. This case highlights the need for a complete evaluation in patients of hyperaldosteronism if overlapping symptoms of hypercortisolism are encountered, to avoid post-operative adrenal crisis.