Cushing with transition from pituitary to adrenal origin. Study with SPECT scintigraphy of the adrenal cortex with norcholesterol-I 131 in a case |
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Authors: | V Araya J Jofré P Hidalgo T Massardo J Amat H Pumarino |
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Affiliation: | Departamento de Cirugía, Hospital Clínico de la Universidad de Chile, Santiago de Chile. |
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Abstract: | The case of a 49 yr old alcoholic women with clinical and laboratory findings that suggested a Cushing syndrome is presented. The functional tests showed cortisol suppression greater than 50% of the basal value with 8 mg of dexamethasone and no response in the combined dexamethasone/desmopressin test. Pituitary Nuclear Magnetic Resonance (NMR) was negative, Abdominal Computed Axial Tomography suggested hyperplastic adrenal glands; adrenal nodules were not found in the NMR. Pituitary or hipothalamic Cushing with secondary autonomous micronodular adrenal hyperplasia was suspected. Norcholesterol-I131 SPECT scintigraphy under dexamethasone suppression demonstrated a functional adrenal hyperplasia which was hystologically confirmed. |
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