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An adrenal tumour secreting multiple hormones

Authors:

HN Rajaratnam ,

Nawaloka Hospital, LK
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SA Abhayaratna,

National Hospital of Sri Lanka, LK
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NP Somasundaram,

National Hospital of Sri Lanka, LK
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A Samarasekara,

National Hospital of Sri Lanka, LK
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SK Kollure

National Hospital of Sri Lanka, LK
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Abstract

A right homogeneous adrenal tumor was found incidentally, during abdominal computed tomography in a 72-year-old female patient, presenting with hypertension of 2 years duration. She had an elevated Aldosterone: Renin Ratio (ARR) and primary hyperaldosteronism was confirmed with a fludrocortisone suppression test. Plasma basal cortisol and adrenocorticotropic hormone (ACTH) levels were normal, but the plasma cortisol concentration could not be suppressed with dexamethasone. Therefore, an adrenal cortical adenoma with primary hyperaldosteronism and subclinical hypercortisolism was suspected. Urinary total metanephrines and vanillylmandelic acid (VMA) levels were also marginally elevated, indicating the possibility of a pheochromocytoma. After right adrenalectomy, the tumour was histologically demonstrated to be a pheochromocytoma, and the levels of all three hormone groups viz corticosteroid, mineralocorticoid and metanephrine levels normalized, indicating the possibility of a cosecretory small adrenocortical microadenoma.

DOI: http://dx.doi.org/10.4038/sjdem.v4i1.7250

Sri Lanka Journal of Diabetes, Endocrinology and Metabolism 2014; 4: 30-34

How to Cite: Rajaratnam, H. et al., (2014). An adrenal tumour secreting multiple hormones. Sri Lanka Journal of Diabetes Endocrinology and Metabolism. 4(1), pp.30–34. DOI: http://doi.org/10.4038/sjdem.v4i1.7250
Published on 03 Aug 2014.
Peer Reviewed

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