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. 2022 Aug 11;12(8):1937.
doi: 10.3390/diagnostics12081937.

ACTH-Independent Cushing's Syndrome Caused by an Ectopic Adrenocortical Adenoma in the Renal Hilum

Zhixin Hao  1   2 , Jie Ding  1   2 , Li Huo  1   2 , Yaping Luo  1   2
Affiliations

ACTH-Independent Cushing's Syndrome Caused by an Ectopic Adrenocortical Adenoma in the Renal Hilum

Zhixin Hao et al. Diagnostics (Basel). .

Abstract

We report a rare case of Cushing's syndrome induced by an ectopic adrenocortical adenoma. A 57-year-old woman was diagnosed with adrenocorticotropic hormone (ACTH)-independent Cushing's syndrome based on clinical manifestation and laboratory information. She was found to have a mass in the left renal hilum via contrast-enhanced computed tomography (CT). The mass was negative, as seen in somatostatin receptor imaging with 99mTc-hydrazinonicotinyl-Tyr3-octreotide (HYNIC-TOC), and showed mild fluorodeoxyglucose (FDG) activity via positron emission tomography (PET)/CT. The results of adrenal venous sampling suggested a left-side adrenal origin of hypercortisolism, possibly secreted by the mass in the renal hilum. Histopathology after surgical resection of the mass confirmed an ectopic adrenocortical adenoma, which was responsible for the patient's Cushing's syndrome. During the 8-month follow-up after surgery, no recurrence of Cushing's syndrome was found.

Keywords: 18F-FDG PET/CT; Cushing’s syndrome; ectopic adrenocortical adenoma; somatostatin receptor imaging.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Imaging analysis of the patient. (A,B) Abdominal contrast-enhanced CT showed bilateral adrenal glands were atrophic without any nodules or hyperplasia (arrowheads), and a mass with mild enhancement in the left renal hilum (arrows). (C,D) 99mTc-HYNIC-TOC SPECT/CT showed the mass was negative with somatostatin receptor imaging (arrows). (E,F) 18F-FDG PET/CT revealed mild FDG activity of the mass (arrows).
See this image and copyright information in PMC

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