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BMC Endocrine Disorders

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Open Access 01-12-2014 | Case report

Suspected metastatic adrenocortical carcinoma revealing as pulmonary Kaposi sarcoma in adrenal Cushing’s syndrome

Authors: Margarita Bala, Cristina L Ronchi, Josef Pichl, Vanessa Wild, Stefan Kircher, Bruno Allolio, Stefanie Hahner

Published in: BMC Endocrine Disorders | Issue 1/2014

Abstract

Background

Kaposi sarcoma (KS) is a malignant disease most commonly diagnosed in the setting of a human immunodeficiency virus (HIV) infection and in patients receiving immunosuppressive treatment. Pulmonary KS has never been reported in association with endogenous Cushing’s syndrome (CS).

Case presentation

A 60-year-old woman presented with symptoms and signs of CS. Adrenal CS was confirmed by standard biochemical evaluation. Imaging revealed a right adrenal lesion (diameter 3.5 cm) and multiple pulmonary nodules, suggesting a cortisol-secreting adrenal carcinoma with pulmonary metastases. The patient underwent right adrenalectomy with a pathohistological diagnosis of an adrenal adenoma. Subsequent thoracoscopic wedge resection of one lung lesion revealed pulmonary KS with positive immunostaining for human herpes virus 8 (HHV-8). HIV-serology was negative. Hydrocortisone replacement was initiated for secondary adrenal insufficiency after surgery. Post-operative follow up imaging showed complete remission of all KS-related pulmonary nodules solely after resolution of hypercortisolism.

Conclusion

KS may occur in the setting of endogenous CS and may go into remission after cure of hypercortisolism without further specific treatment.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6823/14/63/prepub

Title: Suspected metastatic adrenocortical carcinoma revealing as pulmonary Kaposi sarcoma in adrenal Cushing’s syndrome
Authors: Margarita Bala
Cristina L Ronchi
Josef Pichl
Vanessa Wild
Stefan Kircher
Bruno Allolio
Stefanie Hahner
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: BMC Endocrine Disorders / Issue 1/2014
Electronic ISSN: 1472-6823
DOI: https://doi.org/10.1186/1472-6823-14-63

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