Abstract
Cushing's syndrome is a pathological condition where surgery may be lifesaving. The proper diagnosis depends upon the hormonal pattern of the patient, various dynamic tests and imagistic investigations. We report a case of a patient with Cushing's syndrome, with bilateral adrenal tumors and a pituitary microadenoma. She presented increased levels of basal cortisol, unsuppressed during a low and a high dose Dexamethasone test. She underwent right laparoscopic adrenalectomy and developed acute adrenal insufficiency. Two years after the intervention, she still requires adrenal substitution therapy. Acute adrenal crisis is a serious complication of adrenal surgery, with high mortality if unrecognized.
Celsius.
MeSH terms
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Adenoma / complications
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Adenoma / diagnosis*
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Adenoma / surgery
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Adrenal Gland Neoplasms / complications
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Adrenal Gland Neoplasms / diagnosis*
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Adrenal Gland Neoplasms / surgery
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Adrenal Insufficiency / drug therapy
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Adrenal Insufficiency / etiology*
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Adrenalectomy / adverse effects*
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Adult
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Body Mass Index
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Cushing Syndrome / complications
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Cushing Syndrome / diagnosis*
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Cushing Syndrome / surgery
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Diabetes Mellitus, Type 2 / complications
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Drug Therapy, Combination
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Female
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Follow-Up Studies
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Glucocorticoids / therapeutic use
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Humans
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Hypertension / complications
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Hypoglycemic Agents / therapeutic use
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Incidental Findings*
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Laparoscopy*
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Metformin / therapeutic use
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Obesity / complications
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Pituitary Neoplasms / complications
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Pituitary Neoplasms / diagnosis*
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Risk Factors
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Treatment Outcome
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Treatment Refusal
Substances
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Glucocorticoids
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Hypoglycemic Agents
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Metformin