Adrenal Disorders 100 Cases from the Adrenal Clinic

Section A. Incidentally Discovered Adrenal Mass
Case #1: 45-Year Old Woman with an Incidentally Discovered Large Adrenal Mass
Case #2: Adrenal Mass in a Patient with History of Extra-adrenal Malignancy: the Role of Imaging
Case #3: Incidentally Discovered Adrenal Mass in a Patient with History of Extra-adrenal Malignancy: the Role of Adrenal Biopsy
Case #4: Nonfunctioning Lipid Rich Adrenocortical Adenoma-Role of Follow-up
Case #5: 54-Year Old Woman with an Incidentally Discovered Adrenal Mass and Abnormal Dexamethasone Suppression Test: Role of Adrenalectomy
Case #6: Lipid Poor Adrenal Masses-The Case for Aggressive Management

Section B. Primary Aldosteronism
Case #7: Primary Aldosteronism-When Adrenal Venous Sampling is not Needed Before Unilateral Adrenalectomy
Case #8: Primary Aldosteronism with Unilateral Adrenal Nodule on Computed Tomography
Case #9: Primary Aldosteronism with Bilateral Adrenal Nodules on Computed Tomography
Case #10: Primary Aldosteronism Caused by Unilateral Adrenal Hyperplasia
Case #11: Primary Aldosteronism in a Patient with Bilateral Macronodular Adrenal Hyperplasia and Associated Clinically Important Cortisol Co-secretion
Case #12: Primary Aldosteronism in a Patient with an Adrenal Macroadenoma and Clinically Important Cortisol Co-secretion
Case #13: Primary Aldosteronism in a Patient Treated with Spironolactone
Case #14: Failed Catheterization of the Right Adrenal Vein-When Incomplete Adrenal Venous Sampling Data Can Be Used to Direct a Surgical Cure
Case #15: Primary Aldosteronism: When Adrenal Venous Sampling Shows Suppressed Aldosterone Secretion From Both Adrenal Glands

Section C. ACTH-Independent Cushing Syndrome
Case #16: 28-Year-Old Woman with Remote History of Adrenal Mass Presenting with New Onset Hypertension and Weight Gain
Case #17: 26-Year-Old Woman with a Discrepant Work-up for Cushing Syndrome Subtype
Case #18: 45-Year-Old Woman with Corticotropin-Independent Cushing Syndrome and Bilateral Adrenal Adenomas
Case #19: Corticotropin-Independent Cushing Syndrome in a Patient with “Normal” Adrenal Imaging
Case #20: 66-Year-Old Woman with Corticotropin-Independent Hypercortisolism and Bilateral Macronodular Adrenal Hyperplasia
Case #21: 35-Year-Old Woman with Low Bone Density and Fractures
Case #22: Carney Triad (Pentad) and Adrenal Adenoma with Clinically Important Cortisol Secretory Autonomy
 

Section D. Adrenal Cortical Carcinoma and Oncocytic Neoplasm
Case #23: Adrenal cortical carcinoma in a patient with history of adrenal incidentaloma
Case #24: Unexpected Diagnosis of Adrenal Cortical Carcinoma: Role of Urinary Steroid Profiling
Case #25: Oncocytic adrenocortical carcinoma
Case #26: Mitotane therapy in the ENSAT Stage II Adrenocortical Carcinoma
Case #27: Cortisol-Secreting Metastatic Adrenocortical Carcinoma-Role for Surgical Debulking of the Primary Tumor
Case #28: Adrenocortical Carcinoma and Severe Cushing Syndrome
Case #29: Pure Aldosterone-Secreting Adrenocortical Carcinoma
Case #30: Long-standing Primary Aldosteronism in a Patient Diagnosed with Metastatic Adrenocortical Carcinoma
Case #31: Adrenocortical Carcinoma Associated with Lynch Syndrome
Case #32: Adrenocortical Carcinoma Associated with Multiple Endocrine Neoplasia Type 1
Case #33: Adrenocortical Carcinoma Presenting with Inferior Vena Cava Thrombus
Case #34: Management of Mitotane Therapy in Adrenocortical Carcinoma

Section E. Pheochromocytoma and Paraganglioma
Case #35: Most Pheochromocytomas Grow Slowly
Case #36: The “Prebiochemical” Pheochromocytoma
Case #37: Huge Catecholamine-Secreting Tumor
Case#38: Metyrosine Use in a Patient with Metastatic Pheochromocytoma
Case #39: Pheochromocytoma in a Patient with Neurofibromatosis Type 1
Case #40: New Diagnosis of Multiple Endocrine Neoplasia Type 2A in a Patient with Bilateral Pheochromocytomas
Case #41: Pheochromocytoma in a Patient with von Hippel Lindau Disease
Case #42: Bilateral Pheochromocytoma in a Patient with MYC-associated Protein X (MAX) Genetic Predisposition
Case #43: The Cystic Pheochromocytoma
Case #44: Skull Base and Neck Paragangliomas-Considerations for the Endocrinologist
Case #45: Cardiac Paraganglioma.
Case #46: Pheochromocytoma in Multiple Endocrine Neoplasia Type 2B
Case #47: Metastatic Paraganglioma-An Approach to Management and the Use Serial Imaging to Assess Rate of Tumor Progression
Case #48: Metastatic Pheochromocytoma-Role for 68-Ga DOTATATE PET CT
Case #49: Carney Triad (Pentad) and Catecholamine-Secreting Paragangliomas
Case #50: Metastatic Paraganglioma-Role For Systemic Chemotherapy
Case #51: Cryoablation Therapy for Metastatic Paraganglioma
Case #52: Paraganglioma in a patient with cyanotic cardiac disease
Case #53: Metastatic Paraganglioma-Role For External Beam Radiation Therapy
 

Section F. Corticotropin (ACTH)-Dependent Hypercortisolism
Case #54:ACTH-Dependent Cushing Syndrome can be frequently misdiagnosed
Case #55: ACTH-Dependent Cushing Syndrome-Role for Inferior Petrosal Sinus Sampling
Case #56: ACTH-Dependent Cushing Syndrome-When Inferior Petrosal Sinus Sampling is Not Needed
Case #57: Severe ACTH-Dependent Cushing Syndrome Due to a Pituitary Adenoma
Ectopic Cushing Syndrome Associated with Multiple Endocrine Neoplasia Type 2B
Case #59: Ectopic Cushing Syndrome Treated with Cryoablation 
Case #60: Cyclical Ectopic Cushing Syndrome
Case #61: Mild Cushing Syndrome Associated with Ectopic Corticotropin Secretion
Case #62: Bilateral Adrenal Cryoablation in Corticotropin-dependent Cushing Syndrome
Case #63: Cushing Syndrome Associated with Ectopic Corticotropin and Corticotropin Releasing Hormone Secreting Pheochromocytoma
Case #64: Cushing Syndrome in the Setting of Multiple Endocrine Neoplasia Type 1

Section G. Other Adrenal Masses
Case #65: Adrenal Myelolipoma-A Computed Tomography Diagnosis
Case #66: Adrenal Schwannoma
Case #67: Trauma-Related Unilateral Adrenal Hemorrhage
Case #68: Bilateral Adrenal Hemorrhage
Case #69: Primary Adrenal Teratoma
Case #70: The Adrenal Stone
Case #71: Simple Adrenal Cyst
Case #72: Adrenal Cystic Lymphangioma
Case #73: Adrenal Hemangioma
Case #74: Adrenal Ganglioneuroma
Case #75: 42-Year-Old Woman with a Large Adrenal Mass  
Case #76: Primary Adrenal Leiomyosarcoma
Case #77: Primary Adrenal Lymphoma
Case #78. 39-Year-Old Man with a Large Adrenal Mass 
Case # 79: 59-Year-Old Man with Enlarging Bilateral Adrenal Masses 
Case # 80: 65-Year-Old Man with Primary Adrenal Insufficiency  
Case #81: 47-Year-Old Man with Primary Adrenal Insufficiency
Case #82: Bilateral Adrenal Myelolipoma-Think of Congenital Adrenal Hyperplasia
Case #83: A Unilateral Lipid Poor Adrenal Mass-An Atypical Presentation of Adrenal Histoplasmosis
Case #84: Bilateral Macronodular Adrenal Hyperplasia (BMAH) in the Setting of Multiple Endocrine Neoplasia Type 1
Case #85: Pseudo-Adrenal Masses

Section H. Adrenal and Ovarian Hyperandrogenism
Case #86: A Huge Adrenal Myelolipoma in a Patient with a Suboptimally Controlled Congenital Adrenal Hyperplasia
Case #87: Balancing Glucocorticoid and Androgen Excess in Congenital Adrenal Hyperplasia
Case #88: Dehydroepiandrosterone-sulfate (DHEA-S): The “Love it” or “Hate it” Hormone
Case #89: Sorting out the Source of Androgen Excess in a Postmenopausal Woman with an Adrenal and an Ovarian Mass
Case #90: Primary Testosterone-Secreting Adrenocortical Carcinoma in a Premenopausal Woman.
Case #91: Premenopausal Woman with Testosterone-secreting Ovarian Tumor
Case #92: Sorting out the Source of Androgen Excess in a Postmenopausal Woman with an Adrenal Mass
Case #93: Testosterone-Secreting Benign Adrenal Adenoma in a Postmenopausal Woman

Section I. Adrenal Disorders in Pregnancy
Case #94: Malignant Pheochromocytoma in Pregnancy
Case #95: Catecholamine-Secreting Paraganglioma in Pregnancy
Case #96: The Peripartum Diagnosis of Pheochromocytoma and a Genetic Mystery Solved
Case #97. History of Pregnancy in a 41-Year-Old Woman with Undiagnosed Cushing syndrome
Case #98: Pregnancy in a Patient with Primary Adrenal Insufficiency
Case #99: Pregnancy in a Patient with 21-Hydroxylase Deficiency
Case #100: Primary Aldosteronism in Pregnancy

By William F. Young, Jr., MD, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Tyson Family Endocrinology Clinical Professor; Professor of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota and Irina Bancos, MD, Associate Professor, Division of Endocrinology and Metabolism at the Mayo Clinic, Rochester, Minnesota