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Spontaneous rupture of adrenal incidentaloma in a patient with subclinical Cushing’s syndrome, whose clinical expression is metabolic syndrome

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Abstract

A 68-year-old female with enlarged bilateral adrenal glands who was being monitored for metabolic syndrome (MetS) and subclinical Cushing’s syndrome was admitted to our hospital because of rupture of the left adrenal gland. We performed abdominal aortography and embolization of the left middle adrenal artery, and the patient’s pain resolved soon afterwards. After the left adrenal rupture, endocrinological studies still showed subclinical Cushing’s syndrome, and she exhibited no changes in the metabolic disorders. Because she refused removal of the left adrenal gland, we observed her clinical course carefully. One year after the adrenal gland rupture, abdominal computed tomography revealed complete absorption of the retroperitoneal hemorrhage and 131I-adosterol scintigraphy showed a similar result to that previously found. Although adrenal rupture is a rare condition, we should be aware of its possibility during the follow-up of incidental adrenal tumors. Subclinical Cushing’s syndrome has many common features with lifestyle diseases, such as excessive visceral fat, hypertension, metabolic disorders of glucose and lipids. Careful examinations are needed to follow up many patients with lifestyle-related diseases or MetS for a long period.

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References

  1. Morton NM, Paterson JM, Masuzaki H. Novel adipose tissue-mediated resistance to diet-induced visceral obesity in 11 beta-hydroxysteroid dehydrogenase type 1-deficient mice. Diabetes. 2004;53:931–8.

    Article  CAS  PubMed  Google Scholar 

  2. Wolf G. Glucocorticoids in adipocytes stimulate visceral obesity. Nutr Rev. 2002;60:148–51.

    Article  PubMed  Google Scholar 

  3. Canton E. Apoplexy of the supra-renal capsule. Trans Pathol Soc Lond. 1863;14:257.

    Google Scholar 

  4. Kovacs KA, Lam YM, Pater JL. Bilateral massive adrenal hemorrhage. Assessment of putative risk factors by the case control method. Medicine. 2001;80:45–53.

    Article  CAS  PubMed  Google Scholar 

  5. Hinrichs CR, Singer A, Maldjian P, et al. Inferior vena cava thrombosis: a mechanism of posttraumatic adrenal hemorrhage. Am J Roentgenol. 2001;177:357–8.

    Article  CAS  Google Scholar 

  6. Daniel R. Clinical update on the management of adrenal hemorrhage. Curr Urol Rep. 2009;10:78–83.

    Article  Google Scholar 

  7. Catalano O. Retroperitoneal hemorrhage due to a ruptured adrenal myelolipoma: a case report. Acta Radiol. 1996;37:688–90.

    CAS  PubMed  Google Scholar 

  8. Wong KW, Lee IP, Sun WH. Case report: rupture and growth of adrenal myelolipoma in two patients. Br J Radiol. 1996;69:873–5.

    Article  CAS  PubMed  Google Scholar 

  9. Terachi T, Terai A, Yoshida S, Yokota K, Fukunaga M. Spontaneous rupture of adrenal phaeochromocytoma: a case report. Urol Int. 1989;44:235–7.

    Article  CAS  PubMed  Google Scholar 

  10. Tanaka K, Noguchi S, Shuin T, Kinoshita Y, Kubota Y, Hosaka M. Spontaneous rupture of adrenal phaeochromocytoma: a case report. J Urol. 1994;151:120–1.

    CAS  PubMed  Google Scholar 

  11. Wenisch HJ, Klempa I. Rupture of a phaeochromocytoma into the free abdominal cavity. Case report. Chirurg. 1982;53:154–6.

    CAS  PubMed  Google Scholar 

  12. Saito T, Kurumada S, Kawakami Y, Go H, Uchiyama T, Ueki K. Spontaneous hemorrhage of an adrenal cortical adenoma causing Cushing’s syndrome. Urol Int. 1996;56:105–6.

    Article  CAS  PubMed  Google Scholar 

  13. Baccot S, Tiffet O, Bonnot P, Perrot L, Cuilleret J. Bilateral post-traumatic adrenal hemorrhage. Report of a case with acute adrenal insufficiency. Ann Chir. 2000;125:273–5.

    Article  CAS  PubMed  Google Scholar 

  14. Chen KT, Lin TY, Foo NP, et al. Traumatic adrenal haematoma: a condition rarely recognised in the emergency department. Injury. 2007;38:584–7.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

Yasumitsu Takahi, Sachiko Tamba, Yosuke Sekii, Akihito Kamoto, Toshiaki Yoshioka, Hiroshi Yamamoto, Mitsuaki Kyo, Yoshinari Obata, Kenji Saisho, Koji Yamamoto, Yuya Yamada, and Yuji Matsuzawa declare that they have no conflict of interest.

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Correspondence to Yasumitsu Takahi.

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Takahi, Y., Tamba, S., Sekii, Y. et al. Spontaneous rupture of adrenal incidentaloma in a patient with subclinical Cushing’s syndrome, whose clinical expression is metabolic syndrome. Diabetol Int 6, 232–237 (2015). https://doi.org/10.1007/s13340-014-0192-9

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  • DOI: https://doi.org/10.1007/s13340-014-0192-9

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