Ectopic Cortisol-producing Adrenocortical Adenoma Detected by 131I-6β-iodomethyl-norcholesterol Scintigraphy

Seisuke Sato; Hitomi Imachi; Toshihiro Kobayashi; Kensaku Fukunaga; Jingya Lyu; Tao Dong; Yuuki Yoshioka; Takanobu Saheki; Youko Fukata; Natsuki Ban; Kurumi Urushihara; Kyuuichi Kadota; Koji Murao

doi:10.2169/internalmedicine.4180-19

CASE REPORTS

Ectopic Cortisol-producing Adrenocortical Adenoma Detected by 131I-6β-iodomethyl-norcholesterol Scintigraphy

Seisuke Sato, Hitomi Imachi, Toshihiro Kobayashi, Kensaku Fukunaga, Jingya Lyu, Tao Dong, Yuuki Yoshioka, Takanobu Saheki, Youko Fukata, Natsuki Ban, Kurumi Urushihara, Kyuuichi Kadota, Koji Murao

Author information

Seisuke Sato
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Hitomi Imachi
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Toshihiro Kobayashi
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Kensaku Fukunaga
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Jingya Lyu
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Tao Dong
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Yuuki Yoshioka
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Takanobu Saheki
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Youko Fukata
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Natsuki Ban
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Kurumi Urushihara
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Kyuuichi Kadota
Department of Pathology, Faculty of Medicine, Kagawa University, Japan
Koji Murao
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan

Keywords: ectopic adrenocortical adenoma, cortisol-producing adrenocortical adenomas, Cushing's syndrome, scintigraphy

JOURNAL OPEN ACCESS

2020 Volume 59 Issue 14 Pages 1731-1734

DOI https://doi.org/10.2169/internalmedicine.4180-19

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Abstract

A 50-year-old man was referred to our department for overt Cushing's syndrome (CS). His plasma cortisol concentrations were 314 μg/L, and his urinary cortisol concentrations were 431 μg/day. The plasma adrenocorticotropic hormone (ACTH) concentration was below the detectable limit. Computed tomography revealed atrophy of both adrenal glands and the presence of a left pararenal tumor. 131I-6β-iodomethyl-norcholesterol scintigraphy showed an intense uptake by the left pararenal tumor. These findings suggested that the left pararenal tumor was ectopic cortisol-producing adrenocortical adenoma. This case serves as a reminder that 131I-6β-iodomethyl-norcholesterol scintigraphy is an effective method for diagnosing ACTH-independent CS in which no adrenal tumor has been found.

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