Adrenal myelolipoma(s) as presenting manifestation of subclinical Cushing’s disease (eutopic ACTH-dependent Cushing’s syndrome)

  1. Partha Pratim Chakraborty1,
  2. Shinjan Patra1,
  3. Sugata Narayan Biswas1,
  4. Rana Bhattacharjee2

+Author Affiliations


  1. 1Department of MedicineMidnapore Medical College and HospitalMidnaporeWest Bengal, India

  2. 2Department of Endocrinology and MetabolismIPGME&R/SSKM HospitalKolkataWest Bengal, India
  1. Correspondence to Dr Partha Pratim Chakraborty, docparthapc@yahoo.co.in
  • Accepted 5 August 2017
  • Published 16 August 2017

Summary

Primary adrenal myelolipomas, relatively rare benign tumours of the adrenal cortex are typically unilateral, hormonally inactive and asymptomatic, hence often diagnosed as ‘adrenal incidentaloma’. Bilateral adrenal myelolipomas, in particular, may be associated with underlying endocrinopathies associated with elevated circulating adrenocorticotropic hormone (ACTH) concentration.

Subclinical cortisol hypersecretion, irrespective of its ACTH dependency, does not manifest typical clinical phenotype of hypercortisolemia, and thus termed subclinical Cushing’s syndrome.

In this article, hormonal evaluation in a middle-aged woman with diabetes, hypertension and incidentally discovered unilateral adrenal myelolipoma revealed underlying subclinical Cushing’s disease. Abdominal CT revealed another tiny focus in the contralateral adrenal gland, probably representing incipient myelolipoma.

From (you may buy the whole article at this link) http://casereports.bmj.com/content/2017/bcr-2017-221674.short?rss=1

One Response

  1. I had surgery to remove pit tumor because of Cushings. The surgeon nicked the pituitary giving me adrenal insufficiency. In Sept 2016 went into adrenal crises was given too much prednisone developed Cushings again. I am working with an MD with MSc who is an expert in nutrional biochemistry. He also does alternative medicine. His approach has given me a better insight into this disease than my endocrinologist has offered. Through blood work I learned my B12 and D were extremely low. Everyone who suspects Cushings on your site should have these levels tested. Also learned many more things that have helped me to cope with Cushings better. I need to make people on your site aware of this and other things but don’t know how to go about it. My email address is janbarrett7@hotmail.com. My phone #is 1- 905- 984- 3255. I am in Canada. Can you please contact me so I can tell you what I have learned which may help others.

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