Síndrome de Cushing provocado por carcinoma suprarrenal gigante. Caso clínico

We report a previously healthy 34-year-old woman, presenting with a seven-month history of arterial hypertension, amenorrhea, weight gain, facial edema, acne, hirsutism and low back pain. A CT scan showed a right adrenal mass of 18 × 13 × 12.5 cm, and multiple vertebral and rib fractures. The hormon...

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Autores principales: Zapata Pizarro,Antonio, Galleguillos Valdivia,Michel, García Jara,Víctor, Espinoza Cohen,Baldo, Ablan Candia,Franklin, Güenchor García,David, Valenzuela Cruz,José
Lenguaje:Spanish / Castilian
Publicado: Sociedad Médica de Santiago 2020
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Acceso en línea:http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020001101679
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Sumario:We report a previously healthy 34-year-old woman, presenting with a seven-month history of arterial hypertension, amenorrhea, weight gain, facial edema, acne, hirsutism and low back pain. A CT scan showed a right adrenal mass of 18 × 13 × 12.5 cm, and multiple vertebral and rib fractures. The hormonal study confirmed Cushing's Syndrome. Ketoconazole, spironolactone, cotrimoxazole, calcium / vitamin D were started. An adrenalectomy with a right nephrectomy were performed. The excised tumor measured 16 cm and weighed 1.55 kg. There was tumor embolism and a 4 mm soft tissue involvement (pT3NxMx). The right kidney was free of tumor. The patient was treated with chemotherapy (etoposide plus cisplatin). Study of vertebral fractures with magnetic resonance (MRI) showed crush fractures, without images of metastatic bone lesions. One year after surgery, a CT scan showed no signs of tumor recurrence. The patient was lost from follow-up thereafter.