A Cautionary Case: Adrenal Insufficiency after Unilateral Adrenalectomy for Adrenocortical Carcinoma

摘要: Subclinical Cushing’s syndrome among patients with incidentally discovered adrenal masses has been well documented in the literature. This population does not exhibit classic signs of syndrome, but nonetheless present postope rative insufficiency after unilateral adrenalectomy nonfunctioning incidentalomas. Further, results extensive preoperative testing do correlate postoperative hypoadrenalism adequate sensitivity. The patient is an 84-year-old male, who presented vague complaints abdominal pain and fatigue, computed tomography (CT) scan demonstrating enlarging left gland up to 5.5 cm. had no evidence hypothalamic-pituitary-adrenal axis dysfunction based on history, physical examination testing. Thus, lesion was presumed nonfunctional excised laparos copically. Pathology demonstrated unfortunate diagnosis adrenocortical carcinoma (ACC). On day 1, exhibited hypotension hypoglycemia, a cortisol level 0.3 mg/dl. responded hydrocortisone, supporting hypoadrenalism. ACC rare aggressive tumor, only 300 cases per year United States. there paucity data related pre- management. Since third tumors, postsurgical care are literature from incidentalomas until further research establishes guidelines. Our experience acute setting suggests need for routine levels.