Adrenocorticotropic Hormone-Independent Cushing Syndrome Manifesting During Pregnancy |
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| Affiliation: | 1. Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy;2. Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy;3. Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, UK;4. The Endocrine Unit, The Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK;5. Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;1. Centre of Lipids Engineering and Applied Research, Ibnu Sina Institute for Scientific and Industrial Research, Universiti Teknologi Malaysia, 81310, UTM, Johor Bahru, Malaysia;2. School of Chemical and Energy Engineering, Faculty Engineering, Universiti Teknologi Malaysia, 81310, UTM, Johor Bahru, Malaysia;3. Faculty of Engineering, Universiti Malaysia Sarawak (UNIMAS), Kota Samarahan, Malaysia;1. Department of Industrial Engineering, University of Salerno, Via Giovanni Paolo II, 132, 84084 Fisciano, SA, Italy;2. Department of Agricultural Sciences, University of Sassari, 07100, Sassari, SS, Italy;3. Department of Chemistry, Biology and Biotechnology, University of Perugia, Via Elce di Sotto, 8, 06123 Perugia, Italy;4. Department of Pharmaceutical Sciences, University of Perugia, Via del Liceo 1, 06123 Perugia, Italy;1. Department of Food Science and Nutrition, National Engineering Laboratory of Intelligent Food Technology and Equipment, Key Laboratory for Agro-Products Postharvest Handling of Ministry of Agriculture, Zhejiang Key Laboratory for Agro-Food Processing, Zhejiang University, Hangzhou 310058, China;2. Department of Biology, The University of North Carolina at Greensboro, Greensboro, NC 27412, USA;1. Department of Food Science and Technology, Faculty of Nutrition and Food Sciences, Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran;2. Drug Applied Research Center & Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran |
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| Abstract: | ObjectiveTo report a case of adrenocorticotropic hormone-independent Cushing syndrome(CS) diagnosed and treated surgically during the third trimester of pregnancy and resulting in delivery of a healthy baby boy.MethodsWe present a detailed case report, and we review and evaluate the English-language literature on CS during pregnancy.ResultsDuring pregnancy, the occurrence of CS is a rare event. The diagnosis of CS during pregnancy is difficult to establish because of the normal physiologic hypercortisolemia of pregnancy. In our patient, laboratory testing revealed a random serum cortisol level of 56.5 μg/dL, a suppressed plasma adrenocorticotropic hormone level (< 5 pg/mL), and a substantially elevated 24-hour urinary cortisol (1,708 μg). Noncontrast magnetic resonance imaging of the abdomen disclosed a 3.5-cm left adrenal mass. Laparoscopic left adrenalectomy was successfully performed during the early third trimester, and a healthy baby was born at 36 weeks of gestation by means of a cesarean delivery.ConclusionThe occurrence of CS during pregnancy is rare; however, when it does occur, adrenal tumors are more common than pituitary tumors. Caution should be used during interpretation of laboratory tests to evaluate for CS during pregnancy because of the normal increase in hypothalamic-pituitary-adrenal axis function during pregnancy. The current case demonstrates the safety and utility of noncontrast magnetic resonance imaging for localization of a tumor during pregnancy, as well as the safe use of laparoscopic surgical treatment of CS during the early third trimester. (Endocr Pract. 2010;16:260-263) |
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