Abstract
Endogenous Cushing’s syndrome is a relatively rare disease. Most cases being ACTH-dependent, ACTH-independent Cushing’s syndrome (AICS) is an even rarer condition [15%–20%]. In more than 95% cases the cause of AICS is unilateral adrenal enlargement caused by adenoma or carcinoma. Bilateral adrenal disease is caused by primary pigmented nodular adrenal dysplasia (PPNAD) and ACTH-independent macro nodular hyperplasia (AIMAH). Only few case reports of the latter condition exist in the radiology literature, PPNAD being the commoner of two as the cause for AICS.
Similar content being viewed by others
References
Nieman LK, Cutler GB Jr (1995) Cushing’s syndrome. In: DeGroot LJ, (ed). Endocrinology. Philadelphia: Saunders, pp 1741–1770
Sohaib SA, Hanson JA, Newell-Price JD, et al. (1999) CT appearance of the adrenal glands in adrenocorticotrophic hormone-dependent Cushing’s syndrome. AJR Am J Roentgenol 172:997–1002
Rockall AG, et al. (2004) CT and MR imaging of the adrenal glands in ACTH- independent Cushing’s syndrome. RadioGraphics 24:435–452
Doppman JL, et al. (2000) Adrenocorticotropin-independent macronodular adrenal hyperplasia: an uncommon cause of primary adrenal hypercortisolism. Radiology 216:797–802
Newell-Price J, Trainer P, Besser M, et al. (1998) The diagnosis and differential diagnosis of Cushing’s syndrome and pseudo-Cushing’s states. Endocr Rev 19:647–672
Lacroix A, Mircescu H, Hamet P (1999) Clinical evaluation of the presence of abnormal hormone receptors in adrenal Cushing’s syndrome. Endocrinologist 9:9–15
Lieberman SA, Eccleshall TR, Feldman D (1994) ACTH-independent massive bilateral adrenal disease [AIMBAD]: a subtype of Cushing’s syndrome with major diagnostic and therapeutic implications. Eur J Endocrinol 131:67–73
Lacroix A, Bolte E, Tremblay J, et al. (1992) Gastric inhibitory polypeptide-dependent cortisol hypersecretion: a new cause of Cushing’s syndrome. N Engl J Med 327:974–980
Resnik Y, Allali Zerah V, Chayvilalle JA, et al. (1992) Food-dependent Cushing’s syndrome mediated by aberrant adrenal sensitivity to gastric inhibitory polypeptide. N Engl J Med 327:981–986
N’diaye N, Tremblay J, Hamet P, et al. (1998) Adrenocortical overexpression of gastric inhibitory polypeptide receptor underlies food-dependent Cushing’s syndrome. J Clin Endocrinol Metab 83:2781–2785
De Herder W, Huffland LJ, Usdin TB, et al. (1996) Food-dependent Cushing’s syndrome resulting from abundant expression of gastric inhibitory polypeptide receptors in adrenal adenoma cells. J Clin Endocrinol Metab 81:3168–3172
Horiba N, Suda T, Aiba M, et al. (1995) Lysine vasopressin stimulation of cortisol secretion in patients with adrenocorticotropinindependent macronodular adrenal hyperplasia. J Clin Endocrinol Metab 80:2336–2341
Lacroix A, Tremblay J, Touyz RM, et al. (1997) Abnormal adrenal and vascular responses to vasopressin mediated by a V1-vasopressin receptor in a patient with adrenocorticotropin-independent macronodular adrenal hyperplasia, Cushing’s syndrome, and orthostatic hypotension. J Clin Endocrinol Metab 82:2414–2422
Iida K, Kaji H, Matsumoto H, et al. (1997) Adrenocorticotrophin-independent macronodular adrenal hyperplasia in a patient with lysine vasopressin responsiveness but insensitivity to gastric inhibitory polypeptide. Clin Endocrinol 47:739–745
Lacroix A, Tremblay J, Rousseau G, et al. (1997) Propranolol therapy for ectopic b-adrenergenic receptors in adrenal Cushing’s syndrome. N Engl J Med 337:429–434
Kirschner MA, Powell RD Jr, Lipsett MB (1964) Cushing’s syndrome: nodular cortical hyperplasia of adrenal glands with clinical and pathological features suggesting adrenocortical tumor. J Clin Endocrinol 24:947–955
Lack EE, Travis WD, Oertel JE (1990) Adrenal cortical nodules, hyperplasia, and hyperfunction. In: Lack EE, (ed). Pathology of the adrenal gland. New York: Churchill Livingstone, pp 75–114
Sesano H, Suzuki T, Nagora H (1994) ACTH-independent macronodular adrenocortical hyperplasia:immunohistochemical and in situ hybridization studies of steroidogenic enzymes. Mod Pathol 7:215–219
Doppman JL, Miller DL, Dwyer AJ, et al. (1988) Macronodular adrenal hyperplasia in Cushing’s disease. Radiology 166:347–352
Neville AM, O’Hare MJ (1985) Histopathology of the human adrenal cortex. Clin Endocrinol Metab 14:791–820
Shinojima H, Kakizaki H, Usuki T, et al. (2001) Clinical and endocrinological features of adrenocorticotropic hormoneindependent bilateral macronodular adrenocortical hyperplasia. J Urol 166:1639–1642
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Verma, A., Mohan, S. & Gupta, A. ACTH-independant macronodular adrenal hyperplasia: imaging findings of a rare condition. Abdom Imaging 33, 225–229 (2008). https://doi.org/10.1007/s00261-007-9236-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00261-007-9236-y