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An Adrenocortical Carcinoma Associated with Non-Islet Cell Tumor Hypoglycemia and Aberrant ACTH Production
Introduction. Adrenocortical carcinomas (ACCs) are infrequently reported to present with severe hypoglycemia syndrome resulting from the secretion of insulin-like growth factor II (IGF-II) by tumor cells. Adrenocorticotropic hormone- (ACTH) independent hypercortisolism is the norm of hormonally acti...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085350/ https://www.ncbi.nlm.nih.gov/pubmed/32231811 http://dx.doi.org/10.1155/2020/2025631 |
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author | Dilrukshi, M. D. S. A. Wickramarachchi, A. W. Abeyaratne, D. D. K. Shine, Brian Jafar-Mohammadi, Bahram Somasundaram, N. P. |
author_facet | Dilrukshi, M. D. S. A. Wickramarachchi, A. W. Abeyaratne, D. D. K. Shine, Brian Jafar-Mohammadi, Bahram Somasundaram, N. P. |
author_sort | Dilrukshi, M. D. S. A. |
collection | PubMed |
description | Introduction. Adrenocortical carcinomas (ACCs) are infrequently reported to present with severe hypoglycemia syndrome resulting from the secretion of insulin-like growth factor II (IGF-II) by tumor cells. Adrenocorticotropic hormone- (ACTH) independent hypercortisolism is the norm of hormonally active ACCs, but aberrant ACTH production by tumor cells can theoretically cause ACTH-dependent hypercortisolism. The purpose of this report was to present a case of an ACC manifested with the co-occurrence of two extremely rare presentations. Case Description. We present a rare case of a 43-year-old male patient admitted with recurrent episodes of severe non-ketotic and non-insulin-mediated hypoglycemia due to IGF-II mediated disease and ACTH-dependent Cushing's syndrome. He was diagnosed with a diffusely disseminated adrenocortical carcinoma with immunohistochemistry of tumor cells showing focal ACTH immunostain positivity. Conclusion. Non-islet cell tumor hypoglycemia and ACTH-dependent Cushing's syndrome are extremely rare presentations of an ACC, and co-occurrence of these entities in a single patient is never reported in the literature. |
format | Online Article Text |
id | pubmed-7085350 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-70853502020-03-30 An Adrenocortical Carcinoma Associated with Non-Islet Cell Tumor Hypoglycemia and Aberrant ACTH Production Dilrukshi, M. D. S. A. Wickramarachchi, A. W. Abeyaratne, D. D. K. Shine, Brian Jafar-Mohammadi, Bahram Somasundaram, N. P. Case Rep Endocrinol Case Report Introduction. Adrenocortical carcinomas (ACCs) are infrequently reported to present with severe hypoglycemia syndrome resulting from the secretion of insulin-like growth factor II (IGF-II) by tumor cells. Adrenocorticotropic hormone- (ACTH) independent hypercortisolism is the norm of hormonally active ACCs, but aberrant ACTH production by tumor cells can theoretically cause ACTH-dependent hypercortisolism. The purpose of this report was to present a case of an ACC manifested with the co-occurrence of two extremely rare presentations. Case Description. We present a rare case of a 43-year-old male patient admitted with recurrent episodes of severe non-ketotic and non-insulin-mediated hypoglycemia due to IGF-II mediated disease and ACTH-dependent Cushing's syndrome. He was diagnosed with a diffusely disseminated adrenocortical carcinoma with immunohistochemistry of tumor cells showing focal ACTH immunostain positivity. Conclusion. Non-islet cell tumor hypoglycemia and ACTH-dependent Cushing's syndrome are extremely rare presentations of an ACC, and co-occurrence of these entities in a single patient is never reported in the literature. Hindawi 2020-03-09 /pmc/articles/PMC7085350/ /pubmed/32231811 http://dx.doi.org/10.1155/2020/2025631 Text en Copyright © 2020 M. D. S. A. Dilrukshi et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Dilrukshi, M. D. S. A. Wickramarachchi, A. W. Abeyaratne, D. D. K. Shine, Brian Jafar-Mohammadi, Bahram Somasundaram, N. P. An Adrenocortical Carcinoma Associated with Non-Islet Cell Tumor Hypoglycemia and Aberrant ACTH Production |
title | An Adrenocortical Carcinoma Associated with Non-Islet Cell Tumor Hypoglycemia and Aberrant ACTH Production |
title_full | An Adrenocortical Carcinoma Associated with Non-Islet Cell Tumor Hypoglycemia and Aberrant ACTH Production |
title_fullStr | An Adrenocortical Carcinoma Associated with Non-Islet Cell Tumor Hypoglycemia and Aberrant ACTH Production |
title_full_unstemmed | An Adrenocortical Carcinoma Associated with Non-Islet Cell Tumor Hypoglycemia and Aberrant ACTH Production |
title_short | An Adrenocortical Carcinoma Associated with Non-Islet Cell Tumor Hypoglycemia and Aberrant ACTH Production |
title_sort | adrenocortical carcinoma associated with non-islet cell tumor hypoglycemia and aberrant acth production |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085350/ https://www.ncbi.nlm.nih.gov/pubmed/32231811 http://dx.doi.org/10.1155/2020/2025631 |
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