ACTH-Independent Cushing's Syndrome Associated with Left Adrenocortical Oncocytoma of Uncertain Malignant Potential.

IF 0.9 Q4 ENDOCRINOLOGY & METABOLISM Case Reports in Endocrinology Pub Date : 2020-09-26 eCollection Date: 2020-01-01 DOI:10.1155/2020/8816527

Giuseppe S Sica, Leandro Siragusa, Bruno Sensi, Vittoria Bellato, Pierangela Floris, Valentina Rovella, Alessandro Mauriello, Monia Di Prete, Rossana Telesca, Valerio Ciavoni, Carmine Cardillo, Nicola Di Daniele, Manfredi Tesauro

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Abstract

Adrenocortical oncocytomas are rare and mostly nonfunctioning neoplasms. We report the case of a 27-year-old woman diagnosed with an ACTH-independent Cushing's syndrome due to left adrenal oncocytoma. She underwent laparoscopic adrenalectomy. Histopathological examination revealed an oncocytoma of uncertain malignant potential with a low Ki-67 proliferation index, inhibin A positivity, and chromogranin A negativity. Electron micrographs confirmed adrenal oncocytoma cells, characterized by the presence of a large amount of mitochondria. The postoperative course was uneventful, and the patient experienced a progressive regression of Cushing-related symptoms. Periodical follow-ups with MRI and cortisol dosage are required due to the neoplasm's uncertain malignant potential. Considerations on the diagnosis, pathology findings, clinical remarks, and interventions are made.

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不依赖acth的库欣综合征与恶性潜能不确定的左肾上腺皮质癌细胞瘤相关。

肾上腺皮质癌细胞瘤是一种罕见的无功能肿瘤。我们报告的情况下，27岁的妇女诊断为acth独立库欣综合征由于左肾上腺嗜酸细胞瘤。她接受了腹腔镜肾上腺切除术。组织病理学检查显示为恶性潜能不确定的癌细胞瘤，Ki-67增殖指数低，抑制素a阳性，嗜铬粒蛋白a阴性。电子显微照片证实肾上腺嗜瘤细胞，其特征是存在大量线粒体。术后过程平稳，患者经历了库欣相关症状的逐渐消退。由于肿瘤的恶性可能性不确定，需要定期随访MRI和皮质醇剂量。考虑到诊断，病理结果，临床评论和干预措施。

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