Clinical and Biochemical Progression in a Patient With Cortisol-Producing Adenoma
Year: 2025
Type: article
Study design: Case Report
Abstract: The widespread use of imaging studies has led to an increased detection rate of adrenal incidentalomas. Among adrenal incidentalomas, mild autonomous cortisol secretion (MACS) is a common etiology. Development of overt Cushing syndrome (CS) from MACS is a rare event with an estimated prevalence of <1%. Herein, we report a case of cortisol-producing adenoma that demonstrated clinical and biochemical progression, resulting in the development of overt CS. A 50-year-old Japanese woman was referred for the evaluation of CS because of elevated blood pressure and peripheral edema. She had been followed for her left adrenal tumor and MACS before but was lost to follow-up for 2 years and 9 months. At presentation, she had cushingoid features. The 1-mg overnight dexamethasone suppression test indicated greater severity of autonomous cortisol secretion than that in the initial assessment. Imaging studies revealed that her left adrenal tumor increased in size. She underwent laparoscopic left adrenalectomy. Histologic and immunohistochemical examinations confirmed a cortisol-producing adenoma. Sequencing analysis identified a somatic GNAS variant (p.Arg201Cys) in the tumor. Patients with MACS can demonstrate clinical and biochemical progression over time. Considering the high prevalence of MACS, predictive tools such as biomarkers to identify these cases are highly desired.
Source: JCEM Case Reports
Institutions: University of Michigan, Kyoto Medical Center
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $930
Funder: Takeda Science Foundation
OpenAlex ID: W7117728676