Laboratory data:

• serum glucose (on admission): 15.90 mmol/L
• HbA1c: 7.40 %
• C-peptide: 3.09 ng/mL
• cortisol (8.00): 14.8 µg/dl
• cortisol (22.00): 14.2 µg/dl
• 24h Cortisol in urine: 777 µg
• AKTH: <1.00 pg/ml

Brain MRI showed no evidence of pituitary microadenoma.

Patient underwent laparoscopic left side adrenalectomy.

Pathologist conclusion was:

• Macroscopically: received tissue material is cut in small pieces, excision line and fatty capsule are difficult to visualize
  • tissue size: 13 x 11 cm
  • bright yellow in color. 
• Microscopically: Adrenal cortical clear cell nodules, with solid, trabecular composition, lacunar hemorrhages and some amount of fibrosis in stroma
  • Capsule intact
  • ICD-O code: M8370/0
• No special immunohistological tests were performed