Abstract
Cushing's syndrome due to adrenal cortical adenoma is usually caused by a unilateral and single lesion. Here the 8th case of Cushing's syndrome caused by bilateral multiple adrenal adenomas is reported. A 39-year-old woman was seen at the hospital because of extreme obesity and hypertention. Physical findings included central obesity, moon face, stria cutis, and buffalo hump. Based on the findings of endocrinological examinations, abdominal CT scanning, venography, and 131I-adrenal scintigraphy, Cushing's syndrome due to the functioning bilateral adrenal adenomas was diagnosed. Total adrenectomy was carried out through an upper abodminal trans verse incision. There were two adrenal adenomas, 15×10×10 mm and 30×20×20 mm, on the right side and one adenoma, 13×10×10 mm, on the left side. All tumors were well-encapsulated and well-defined, showing a brownish-yellow cut surface. In light microscopic findings, coexistence of clear cell regions and compact cell regions presenting as a complex map was seen. It was a typical adenoma. Cushing's syndrome due to bilateral adrenal adenomas is a rare condition, and only 8 cases have been reported in the Japanese literatures so far. The importance of differential diagnosis between bilateral adenomas and adrenal nodular hyperplasia should be emphasized.
