Background:The suppression of the
hypothalamic-pituitary-adrenal axis by cortisol-secreting adrenocortical tumors
is well recognized and requires peri- and postoperative hydrocortisone substitution. Case Presentation: A 48-year-old female patient with
hypertension and progressive weight gain, the clinical signs of hypercorticism
motivated a hormonal workup revealing an independent ACTH Cushing’s syndrome: with urinary free cortisol (UFC) at 649 nmol/24h (4×
normal), adrenocorticotropin hormone (ACTH) at 1.5 ng/l. The rest of the
hormonal workup was not performed due to a lack of financial means. An Adrenal CT scan showed a 4 cm right adrenal adenoma.
The patient underwent a right adrenalectomy with an adrenal adenoma on
pathological examination. The contralateral side was normal. The patient was
treated with hydrocortisone 30mg/d for 6 weeks then 15 mg/d, during the monitoring
we noted a persistence of the adrenal insufficiency for now
4 years. Basal cortisol levels during follow-up were very low (<3 μg/dl)
ruling out the need for synacthen stimulation tests. Conclusion: Adrenal
cortisol tumors are recognized by suppression, the duration of hypothala
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