The importance of adrenal venous sampling in ACTH‑independent Cushing syndrome: A case report and literature review

Tulin,Raluca; Tulin,Adrian; Tomescu,Luminita Florentina; Mihaly,Enyedi; Avino,Adelaida; Socea,Bogdan; Jecan,Cristian-Radu; Stiru,Ovidiu; Spataru,Radu-Iulian

doi:10.3892/etm.2021.10204

The importance of adrenal venous sampling in ACTH‑independent Cushing syndrome: A case report and literature review

Authors:
- Raluca Tulin
- Adrian Tulin
- Luminita Florentina Tomescu
- Enyedi Mihaly
- Adelaida Avino
- Bogdan Socea
- Cristian-Radu Jecan
- Ovidiu Stiru
- Radu-Iulian Spataru
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Affiliations: Department of Embryology, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Anatomy, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Cardiovascular Surgery, ‘Prof. Dr. Agrippa Ionescu’ Clinical Emergency Hospital, 011356 Bucharest, Romania, Department of Plastic and Reconstructive Surgery, ‘Prof. Dr. Agrippa Ionescu’ Clinical Emergency Hospital, 011356 Bucharest, Romania, Department of Surgery, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Cardiovascular Surgery, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Discipline of Pediatric Surgery, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
Published online on: May 18, 2021 https://doi.org/10.3892/etm.2021.10204
Article Number: 772
Copyright: © Tulin et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Independent Cushing's adrenocorticotropic hormone (ACTH) syndrome can have several causes, including adrenal carcinoma or simple adrenal hyperplasia. Although the distinction between malignant and benign can be effectively made through imaging investigations, in the situation where there are bilateral formations, their hormonal activity is impossible to appreciate via non‑invasive techniques. The present study includes the presentation of a clinical case on the basis of which a literature review was made. The clinical case pertains to a 32‑year‑old patient with ACTH‑independent Cushing's syndrome and bilateral adrenal tumor formations leading to the utility of adrenal venous sampling to avoid bilateral adrenalectomy. A literature review was subsequently conducted focusing on articles pertaining to the PICO criteria in order to describe: The diagnosis of adrenal tumor masses, the decision on the type of surgery and most importantly, the impact of adrenal venous sampling in avoiding surgical resection. These interventions severely limit the patients' quality of life.

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