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Published in: Abdominal Radiology 2/2008

01-03-2008

ACTH-independant macronodular adrenal hyperplasia: imaging findings of a rare condition

A case report

Authors: Ashish Verma, Suyash Mohan, Archna Gupta

Published in: Abdominal Radiology | Issue 2/2008

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Abstract

Endogenous Cushing’s syndrome is a relatively rare disease. Most cases being ACTH-dependent, ACTH-independent Cushing’s syndrome (AICS) is an even rarer condition [15%–20%]. In more than 95% cases the cause of AICS is unilateral adrenal enlargement caused by adenoma or carcinoma. Bilateral adrenal disease is caused by primary pigmented nodular adrenal dysplasia (PPNAD) and ACTH-independent macro nodular hyperplasia (AIMAH). Only few case reports of the latter condition exist in the radiology literature, PPNAD being the commoner of two as the cause for AICS.
Literature
1.
go back to reference Nieman LK, Cutler GB Jr (1995) Cushing’s syndrome. In: DeGroot LJ, (ed). Endocrinology. Philadelphia: Saunders, pp 1741–1770 Nieman LK, Cutler GB Jr (1995) Cushing’s syndrome. In: DeGroot LJ, (ed). Endocrinology. Philadelphia: Saunders, pp 1741–1770
2.
go back to reference Sohaib SA, Hanson JA, Newell-Price JD, et al. (1999) CT appearance of the adrenal glands in adrenocorticotrophic hormone-dependent Cushing’s syndrome. AJR Am J Roentgenol 172:997–1002PubMed Sohaib SA, Hanson JA, Newell-Price JD, et al. (1999) CT appearance of the adrenal glands in adrenocorticotrophic hormone-dependent Cushing’s syndrome. AJR Am J Roentgenol 172:997–1002PubMed
3.
go back to reference Rockall AG, et al. (2004) CT and MR imaging of the adrenal glands in ACTH- independent Cushing’s syndrome. RadioGraphics 24:435–452PubMedCrossRef Rockall AG, et al. (2004) CT and MR imaging of the adrenal glands in ACTH- independent Cushing’s syndrome. RadioGraphics 24:435–452PubMedCrossRef
4.
go back to reference Doppman JL, et al. (2000) Adrenocorticotropin-independent macronodular adrenal hyperplasia: an uncommon cause of primary adrenal hypercortisolism. Radiology 216:797–802PubMed Doppman JL, et al. (2000) Adrenocorticotropin-independent macronodular adrenal hyperplasia: an uncommon cause of primary adrenal hypercortisolism. Radiology 216:797–802PubMed
5.
go back to reference Newell-Price J, Trainer P, Besser M, et al. (1998) The diagnosis and differential diagnosis of Cushing’s syndrome and pseudo-Cushing’s states. Endocr Rev 19:647–672PubMedCrossRef Newell-Price J, Trainer P, Besser M, et al. (1998) The diagnosis and differential diagnosis of Cushing’s syndrome and pseudo-Cushing’s states. Endocr Rev 19:647–672PubMedCrossRef
6.
go back to reference Lacroix A, Mircescu H, Hamet P (1999) Clinical evaluation of the presence of abnormal hormone receptors in adrenal Cushing’s syndrome. Endocrinologist 9:9–15CrossRef Lacroix A, Mircescu H, Hamet P (1999) Clinical evaluation of the presence of abnormal hormone receptors in adrenal Cushing’s syndrome. Endocrinologist 9:9–15CrossRef
7.
go back to reference Lieberman SA, Eccleshall TR, Feldman D (1994) ACTH-independent massive bilateral adrenal disease [AIMBAD]: a subtype of Cushing’s syndrome with major diagnostic and therapeutic implications. Eur J Endocrinol 131:67–73PubMedCrossRef Lieberman SA, Eccleshall TR, Feldman D (1994) ACTH-independent massive bilateral adrenal disease [AIMBAD]: a subtype of Cushing’s syndrome with major diagnostic and therapeutic implications. Eur J Endocrinol 131:67–73PubMedCrossRef
8.
go back to reference Lacroix A, Bolte E, Tremblay J, et al. (1992) Gastric inhibitory polypeptide-dependent cortisol hypersecretion: a new cause of Cushing’s syndrome. N Engl J Med 327:974–980PubMedCrossRef Lacroix A, Bolte E, Tremblay J, et al. (1992) Gastric inhibitory polypeptide-dependent cortisol hypersecretion: a new cause of Cushing’s syndrome. N Engl J Med 327:974–980PubMedCrossRef
9.
go back to reference Resnik Y, Allali Zerah V, Chayvilalle JA, et al. (1992) Food-dependent Cushing’s syndrome mediated by aberrant adrenal sensitivity to gastric inhibitory polypeptide. N Engl J Med 327:981–986CrossRef Resnik Y, Allali Zerah V, Chayvilalle JA, et al. (1992) Food-dependent Cushing’s syndrome mediated by aberrant adrenal sensitivity to gastric inhibitory polypeptide. N Engl J Med 327:981–986CrossRef
10.
go back to reference N’diaye N, Tremblay J, Hamet P, et al. (1998) Adrenocortical overexpression of gastric inhibitory polypeptide receptor underlies food-dependent Cushing’s syndrome. J Clin Endocrinol Metab 83:2781–2785PubMedCrossRef N’diaye N, Tremblay J, Hamet P, et al. (1998) Adrenocortical overexpression of gastric inhibitory polypeptide receptor underlies food-dependent Cushing’s syndrome. J Clin Endocrinol Metab 83:2781–2785PubMedCrossRef
11.
go back to reference De Herder W, Huffland LJ, Usdin TB, et al. (1996) Food-dependent Cushing’s syndrome resulting from abundant expression of gastric inhibitory polypeptide receptors in adrenal adenoma cells. J Clin Endocrinol Metab 81:3168–3172PubMedCrossRef De Herder W, Huffland LJ, Usdin TB, et al. (1996) Food-dependent Cushing’s syndrome resulting from abundant expression of gastric inhibitory polypeptide receptors in adrenal adenoma cells. J Clin Endocrinol Metab 81:3168–3172PubMedCrossRef
12.
go back to reference Horiba N, Suda T, Aiba M, et al. (1995) Lysine vasopressin stimulation of cortisol secretion in patients with adrenocorticotropinindependent macronodular adrenal hyperplasia. J Clin Endocrinol Metab 80:2336–2341PubMedCrossRef Horiba N, Suda T, Aiba M, et al. (1995) Lysine vasopressin stimulation of cortisol secretion in patients with adrenocorticotropinindependent macronodular adrenal hyperplasia. J Clin Endocrinol Metab 80:2336–2341PubMedCrossRef
13.
go back to reference Lacroix A, Tremblay J, Touyz RM, et al. (1997) Abnormal adrenal and vascular responses to vasopressin mediated by a V1-vasopressin receptor in a patient with adrenocorticotropin-independent macronodular adrenal hyperplasia, Cushing’s syndrome, and orthostatic hypotension. J Clin Endocrinol Metab 82:2414–2422PubMedCrossRef Lacroix A, Tremblay J, Touyz RM, et al. (1997) Abnormal adrenal and vascular responses to vasopressin mediated by a V1-vasopressin receptor in a patient with adrenocorticotropin-independent macronodular adrenal hyperplasia, Cushing’s syndrome, and orthostatic hypotension. J Clin Endocrinol Metab 82:2414–2422PubMedCrossRef
14.
go back to reference Iida K, Kaji H, Matsumoto H, et al. (1997) Adrenocorticotrophin-independent macronodular adrenal hyperplasia in a patient with lysine vasopressin responsiveness but insensitivity to gastric inhibitory polypeptide. Clin Endocrinol 47:739–745CrossRef Iida K, Kaji H, Matsumoto H, et al. (1997) Adrenocorticotrophin-independent macronodular adrenal hyperplasia in a patient with lysine vasopressin responsiveness but insensitivity to gastric inhibitory polypeptide. Clin Endocrinol 47:739–745CrossRef
15.
go back to reference Lacroix A, Tremblay J, Rousseau G, et al. (1997) Propranolol therapy for ectopic b-adrenergenic receptors in adrenal Cushing’s syndrome. N Engl J Med 337:429–434CrossRef Lacroix A, Tremblay J, Rousseau G, et al. (1997) Propranolol therapy for ectopic b-adrenergenic receptors in adrenal Cushing’s syndrome. N Engl J Med 337:429–434CrossRef
16.
go back to reference Kirschner MA, Powell RD Jr, Lipsett MB (1964) Cushing’s syndrome: nodular cortical hyperplasia of adrenal glands with clinical and pathological features suggesting adrenocortical tumor. J Clin Endocrinol 24:947–955CrossRef Kirschner MA, Powell RD Jr, Lipsett MB (1964) Cushing’s syndrome: nodular cortical hyperplasia of adrenal glands with clinical and pathological features suggesting adrenocortical tumor. J Clin Endocrinol 24:947–955CrossRef
17.
go back to reference Lack EE, Travis WD, Oertel JE (1990) Adrenal cortical nodules, hyperplasia, and hyperfunction. In: Lack EE, (ed). Pathology of the adrenal gland. New York: Churchill Livingstone, pp 75–114 Lack EE, Travis WD, Oertel JE (1990) Adrenal cortical nodules, hyperplasia, and hyperfunction. In: Lack EE, (ed). Pathology of the adrenal gland. New York: Churchill Livingstone, pp 75–114
18.
go back to reference Sesano H, Suzuki T, Nagora H (1994) ACTH-independent macronodular adrenocortical hyperplasia:immunohistochemical and in situ hybridization studies of steroidogenic enzymes. Mod Pathol 7:215–219 Sesano H, Suzuki T, Nagora H (1994) ACTH-independent macronodular adrenocortical hyperplasia:immunohistochemical and in situ hybridization studies of steroidogenic enzymes. Mod Pathol 7:215–219
19.
go back to reference Doppman JL, Miller DL, Dwyer AJ, et al. (1988) Macronodular adrenal hyperplasia in Cushing’s disease. Radiology 166:347–352PubMed Doppman JL, Miller DL, Dwyer AJ, et al. (1988) Macronodular adrenal hyperplasia in Cushing’s disease. Radiology 166:347–352PubMed
20.
go back to reference Neville AM, O’Hare MJ (1985) Histopathology of the human adrenal cortex. Clin Endocrinol Metab 14:791–820PubMedCrossRef Neville AM, O’Hare MJ (1985) Histopathology of the human adrenal cortex. Clin Endocrinol Metab 14:791–820PubMedCrossRef
21.
go back to reference Shinojima H, Kakizaki H, Usuki T, et al. (2001) Clinical and endocrinological features of adrenocorticotropic hormoneindependent bilateral macronodular adrenocortical hyperplasia. J Urol 166:1639–1642PubMedCrossRef Shinojima H, Kakizaki H, Usuki T, et al. (2001) Clinical and endocrinological features of adrenocorticotropic hormoneindependent bilateral macronodular adrenocortical hyperplasia. J Urol 166:1639–1642PubMedCrossRef
Metadata
Title
ACTH-independant macronodular adrenal hyperplasia: imaging findings of a rare condition
A case report
Authors
Ashish Verma
Suyash Mohan
Archna Gupta
Publication date
01-03-2008
Publisher
Springer-Verlag
Published in
Abdominal Radiology / Issue 2/2008
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-007-9236-y

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