Affiliation:
1. 1Department and Endocrine and Metabolic DiseasesBab El Oued Teaching Hospital Algiers, Algiers, Algeria
2. 2Department of PathologyPierre and Marie Curie Centre, Algiers, Algeria
Abstract
Aim
Ovarian corticosteroid-producing tumors are exquisitely rare. Our aim was to describe the first case observed in our practice.
Case history
A 34-year-old female was referred for Cushing’s syndrome (CS) occurring in the postpartum period. Clinical examination showed severe CS with diabetes mellitus, hypertension, and a large mass in the right lower abdomen. Biochemistry demonstrated corticotropin (ACTH)-independent CS (cortisol=1900ng/mL (n=50–250), ACTH<10pg/mL (n=20–46)) with estradiol and testosterone overproduction.
Investigations
Abdomen CT scan revealed a 14cm right ovarian mass and small adrenal glands. Surgical exploration found the ovarian tumor with hemoperitoneum and enlarged lymph nodes. Histological study confirmed adrenocortical tumor located in the ovary with a Weiss score >5, associated with peritoneal and lymph node metastases. Immunohistochemical staining was positive for inhibin-α, melan-A, and SF1, demonstrating tissue of adrenal origin. After surgery, plasma glucose level spontaneously returned to normal. However, the patient died on the second post-surgical day due to catastrophic pulmonary embolism.
Conclusion
In this reported case, clinical, hormonal, histological, and immunohistochemical findings confirmed a cortisol and sex hormone-producing ovarian tumor with peritoneal and lymph node metastases, a very rare but important condition to recognize.
Subject
Endocrinology,General Medicine,Endocrinology, Diabetes and Metabolism
Reference32 articles.
1. Prevalence, etiology and clinical findings of Cushing’s syndrome;Lahera Vargas;Endocrinologiía Nutrición,2009
2. Ectopic Cushing’s syndrome: experience from a tertiary care centre;Bhansali;Indian Journal of Medical Research,2009
3. Management of adrenal incidentaloma;Terzolo;Best Practice & Research: Clinical Endocrinology & Metabolism,2009
4. ACTH-independent Cushing’s syndrome presenting during pregnancy;Pollack;Endocrine Practice,2009
5. ACTH-Independent Cushing’s Syndrome with Bilateral Micronodular Adrenal Hyperplasia and Ectopic Adrenocortical Adenoma
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