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Macronodular adrenal hyperplasia

Case contributed by Ayaz Hidayatov
Diagnosis almost certain

Presentation

Cushing's syndrome

Patient Data

Age: 55 years
Gender: Male

Non-contrast CT shows bilateral markedly enlargement of both adrenals with multiple nodules.

Case Discussion

Macronodular adrenal hyperplasia or adrenocorticotrophic hormone (ACTH) independent macronodular adrenal hyperplasia is a rare cause of Cushing's syndrome. 

Macronodular adrenal hyperplasia is characterized by multiple bilateral adrenocortical nodules.

This form of adrenal hyperplasia typically produces excess cortisol with overt or subclinical Cushings syndrome, but in some cases mineralocorticoids and sexual steroid secretion can also occur.

Bilateral adrenalectomy is the most useful treatment choice for patients with macronodular adrenal hyperplasia and hormonal hypersecretion.

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