Adrenal Cortical Carcinoma Presenting as CSCR.

Q3 Medicine Retinal Cases and Brief Reports Pub Date : 2024-11-22 DOI:10.1097/ICB.0000000000001668

A Reza Gohari, Sara P Modjtahedi, Caleb R Telander, MaxX Kong

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Abstract

Purpose: We describe a case of bilateral chronic central serous chorioretinopathy (CSCR) secondary to adrenal cortical carcinoma.

Methods: Case report of a 70-year-old Hispanic man presenting with bilateral multifocal CSCR.

Results: Clinical findings of bilateral chronic CSCR along with 160 µm of subretinal fluid (SRF) and choroidal thickness greater than 400 µm without enhanced depth optical coherence tomography was noted in a patient presenting with distortion in vision in both eyes and weight gain of 15 pounds, weakness, and fatigue starting 8 months prior. Further endocrine testing showed an elevated 24-hour urinary free cortisol level of 137 µg with no change in serum cortisol levels following low-dose dexamethasone suppression test and undetectable serum adrenocorticotropic hormone (ACTH) levels consistent with ACTH-independent Cushing's syndrome. Imaging of the abdomen revealed heterogeneously enhancing masses, and biopsy of the adrenal tumor led to the diagnosis of adrenal cortical carcinoma. He died 3 weeks after starting hospice care, and only completed one round of chemotherapy.

Conclusion: Adrenal tumors including adrenal cortical carcinoma may present as bilateral chronic central serous chorioretinopathy.

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肾上腺皮质癌表现为CSCR。

目的：我们报告一例继发于肾上腺皮质癌的双侧慢性中枢性浆液性脉络膜视网膜病变（CSCR）。方法：病例报告一名70岁的西班牙裔男性表现为双侧多灶CSCR。结果：临床表现为双侧慢性CSCR伴160µm视网膜下积液（SRF）和脉络膜厚度大于400µm，无增强深度光学相干断层扫描，患者在8个月前出现双眼视力扭曲、体重增加15磅、虚弱和疲劳。进一步的内分泌测试显示24小时尿游离皮质醇水平升高137µg，低剂量地塞米松抑制试验后血清皮质醇水平无变化，血清促肾上腺皮质激素（ACTH）水平未检出，符合ACTH非依赖性库欣综合征。腹部影像显示不均质强化肿块，肾上腺肿瘤活检诊断为肾上腺皮质癌。他在开始临终关怀3周后去世，只完成了一轮化疗。结论：肾上腺肿瘤包括肾上腺皮质癌可表现为双侧慢性中枢性浆液性脉络膜视网膜病变。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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