ACTH-Independent Cushing's Syndrome Associated with Left Adrenocortical Oncocytoma of Uncertain Malignant Potential

Giuseppe S Sica; Leandro Siragusa; Bruno Sensi; Vittoria Bellato; Pierangela Floris; Valentina Rovella; Alessandro Mauriello; Monia Di Prete; Rossana Telesca; Valerio Ciavoni; Carmine Cardillo; Nicola Di Daniele; Manfredi Tesauro

doi:10.1155/2020/8816527

ACTH-Independent Cushing's Syndrome Associated with Left Adrenocortical Oncocytoma of Uncertain Malignant Potential

Case Rep Endocrinol. 2020 Sep 26:2020:8816527. doi: 10.1155/2020/8816527. eCollection 2020.

Affiliations

¹ Department of Surgery, University of Rome "Tor Vergata", 00133 Rome, Italy.
² Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.
³ Department of Experimental Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.
⁴ Department of Internal Medicine, Universitá Cattolica del Sacro Cuore, Rome 00168, Italy.

Abstract

Adrenocortical oncocytomas are rare and mostly nonfunctioning neoplasms. We report the case of a 27-year-old woman diagnosed with an ACTH-independent Cushing's syndrome due to left adrenal oncocytoma. She underwent laparoscopic adrenalectomy. Histopathological examination revealed an oncocytoma of uncertain malignant potential with a low Ki-67 proliferation index, inhibin A positivity, and chromogranin A negativity. Electron micrographs confirmed adrenal oncocytoma cells, characterized by the presence of a large amount of mitochondria. The postoperative course was uneventful, and the patient experienced a progressive regression of Cushing-related symptoms. Periodical follow-ups with MRI and cortisol dosage are required due to the neoplasm's uncertain malignant potential. Considerations on the diagnosis, pathology findings, clinical remarks, and interventions are made.

Publication types

Case Reports