Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Dec 14:2020:7415762.
doi: 10.1155/2020/7415762. eCollection 2020.

Functional Adrenal Collision Tumor in a Patient with Cushing's Syndrome

Cathy Zhou  1 , Ghaneh Fananapazir  1 , Michael J Campbell  2
Affiliations
Case Reports

Functional Adrenal Collision Tumor in a Patient with Cushing's Syndrome

Cathy Zhou et al. Case Rep Endocrinol. .

Abstract

Adrenal collision tumors are rare and produce unique diagnostic challenges for clinicians. We report the case of a 45-year-old woman with obesity and diabetes mellitus and an incidentally-discovered adrenal mass containing macroscopic fat, thought to be a myelolipoma. A functional workup confirmed adrenocorticotropic hormone- (ACTH-) independent Cushing's syndrome. The patient underwent a successful laparoscopic adrenalectomy with pathology showing an adrenal collision tumor consisting of an adrenocortical adenoma and a myelolipoma. Postoperatively, the clinical symptoms, body mass index, and hemoglobin A1C all improved. Clinicians should consider a functional workup in patients with radiographically diagnosed myelolipomas as some may prove to be hormonally active collision tumors.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest regarding the publication of this paper.

Figures

Figure 1
Figure 1
A CT for abdominal pain in November 2012 revealed a presumed adrenal myelolipoma with a focus of macroscopic fat (a). In comparing to a prior exam from April 2007 (b), this mass had grown in size, and subsequent imaging from April 2016 (c) continued to demonstrate growth.
Figure 2
Figure 2
The surgical specimen demonstrates the characteristic macroscopic fat component of the myelolipoma with an adjacent well-circumscribed solid golden yellow adenoma.
Figure 3
Figure 3
Patient weight and hemoglobin A1C graphed over time.
See this image and copyright information in PMC

References

    1. Mayo-Smith W. W., Song J. H., Boland G. L., et al. Management of incidental adrenal masses: a white paper of the acr incidental findings committee. Journal of the American College of Radiology. 2017;14(8):1038–1044. doi: 10.1016/j.jacr.2017.05.001. - DOI - PubMed
    1. Matsuda T., Abe H., Takase M., et al. Case of combined adrenal cortical adenoma and myelolipoma. Pathology International. 2004;54(9):725–729. doi: 10.1111/j.1440-1827.2004.01686.x. - DOI - PubMed
    1. Armand R., Cappola A. R., Horenstein R. B., Drachenberg C. B., Sasano H., Papadimitriou J. C. Adrenal cortical adenoma with excess black pigment deposition, combined with myelolipoma and clinical Cushing’s syndrome. International Journal of Surgical Pathology. 2004;12(1):57–61. doi: 10.1177/106689690401200111. - DOI - PubMed
    1. Cardinalli I. A., de Oliveira-Filho A. G., Mastellaro M. J., Ribeiro R. C., Aguiar S. S. A unique case of synchronous functional adrenocortical adenoma and myelolipoma within the ectopic adrenal cortex in a child with Beckwith-Wiedemann syndrome. Pathology-Research and Practice. 2012;208(3):189–194. doi: 10.1016/j.prp.2011.12.011. - DOI - PubMed
    1. Hisamatsu H., Sakai H., Tsuda S., Shigematsu K., Kanetake H. Combined adrenal adenoma and myelolipoma in a patient with Cushing’s syndrome: case report and review of the literature. International Journal of Urology. 2004;11(6):416–418. doi: 10.1111/j.1442-2042.2004.00815.x. - DOI - PubMed

Publication types