From benign adrenal incidentaloma to adrenocortical carcinoma: an exceptional random event

被引:18
作者
Belmihoub, I. [1 ]
Silvera, S. [2 ]
Sibony, M. [3 ]
Dousset, B. [4 ]
Legmann, P. [5 ]
Bertagna, X. [1 ]
Bertherat, J. [1 ,6 ]
Assie, G. [1 ,6 ]
机构
[1] Hop Cochin, AP HP, Dept Endocrinol, Ctr Rare Adrenal Dis, Paris, France
[2] St Joseph Hosp, Dept Radiol, Paris, France
[3] Hop Cochin, AP HP, Dept Pathol, Paris, France
[4] Hop Cochin, AP HP, Dept Digest & Endocrine Surg, Paris, France
[5] Hop Cochin, AP HP, Dept Radiol A, Paris, France
[6] Univ Paris 05, CNRS, INSERM, U1016,Inst Cochin,UMR8104,Sorbonne Paris Cite, Paris, France
关键词
TUMORIGENESIS; MANAGEMENT; SOCIETY; TUMORS; MASSES;
D O I
10.1530/EJE-17-0037
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
New European guidelines for the management of adrenal incidentalomas were recently released. One of the most novel recommendations is to stop following patients when they present a typical, small and non-secreting adenoma. We report here the case of a 71-year-old man with such an adenoma, who developed an adrenocortical carcinoma (ACC) fourteen years later, with subsequent metastases and death. Clinically, he had a normal blood pressure and no sign of hormonal hypersecretion. The hormonal work-up showed no hormone excess: urinary free cortisol level was normal, the diurnal cortisol rhythm was respected and urinary catecholamine metabolites levels were normal. Computed tomography (CT) scan showed a homogeneous lesion, with a low density. The lesion remained unchanged during the five years of follow-up. Eight years after the last CT, a large right heterogeneous adrenal mass was incidentally discovered during an ultrasound examination. On CT scan, it was a 6 cm heterogeneous tumor. On hormonal work-up, there was no secretion. The patient was operated of an adrenalectomy, and the histology described an ACC with a Weiss score at 8, with no benign contingent. To our knowledge, this is the first case of an ACC occurring in a patient with prior adrenal imaging showing a typical benign adenoma.
引用
收藏
页码:K15 / K19
页数:5
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