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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...

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Autores principales: Dilrukshi, M. D. S. A., Wickramarachchi, A. W., Abeyaratne, D. D. K., Shine, Brian, Jafar-Mohammadi, Bahram, Somasundaram, N. P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2020
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.
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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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