Adrenocortical Carcinoma With Cushing’s Syndrome and Hyperandrogenism in a 28-Year-Old Pregnant Female
To describe a case highlighting a rare malignancy that can be camouflaged by the hormonal milieu of pregnancy. We present the case of a 28-year-old pregnant female who was diagnosed with stage IV metastatic adrenocortical carcinoma at 15-weeks gestation. The patient declined palliative chemotherapy...
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| Published in | AACE clinical case reports Vol. 9; no. 3; pp. 77 - 80 |
|---|---|
| Main Authors | , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Inc
01.05.2023
American Association of Clinical Endocrinology Elsevier |
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| Abstract | To describe a case highlighting a rare malignancy that can be camouflaged by the hormonal milieu of pregnancy.
We present the case of a 28-year-old pregnant female who was diagnosed with stage IV metastatic adrenocortical carcinoma at 15-weeks gestation. The patient declined palliative chemotherapy at first with the hope of continuing her pregnancy. She had elevated dehydroepiandrosterone sulfate, testosterone, and cortisol levels consistent with Cushing’s syndrome and hyperandrogenism. The patient eventually had a spontaneous abortion and elected to start chemotherapy and mitotane treatment. She passed away 3 months after initial presentation.
Adrenocortical carcinoma is difficult to detect and diagnose in pregnant patients because of the physiologic hormonal changes that take place during gestation. The patient described in this case report is an example of this diagnostic challenge.
Adrenocortical carcinoma is a rare, fatal disease that often presents at an advanced stage with limited treatment options making earlier diagnosis imperative; however, diagnosis and treatment are complicated by pregnancy. More data is necessary to determine how best to approach these challenges in future patients. |
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| AbstractList | To describe a case highlighting a rare malignancy that can be camouflaged by the hormonal milieu of pregnancy.
We present the case of a 28-year-old pregnant female who was diagnosed with stage IV metastatic adrenocortical carcinoma at 15-weeks gestation. The patient declined palliative chemotherapy at first with the hope of continuing her pregnancy. She had elevated dehydroepiandrosterone sulfate, testosterone, and cortisol levels consistent with Cushing's syndrome and hyperandrogenism. The patient eventually had a spontaneous abortion and elected to start chemotherapy and mitotane treatment. She passed away 3 months after initial presentation.
Adrenocortical carcinoma is difficult to detect and diagnose in pregnant patients because of the physiologic hormonal changes that take place during gestation. The patient described in this case report is an example of this diagnostic challenge.
Adrenocortical carcinoma is a rare, fatal disease that often presents at an advanced stage with limited treatment options making earlier diagnosis imperative; however, diagnosis and treatment are complicated by pregnancy. More data is necessary to determine how best to approach these challenges in future patients. Background/Objective: To describe a case highlighting a rare malignancy that can be camouflaged by the hormonal milieu of pregnancy. Case Report: We present the case of a 28-year-old pregnant female who was diagnosed with stage IV metastatic adrenocortical carcinoma at 15-weeks gestation. The patient declined palliative chemotherapy at first with the hope of continuing her pregnancy. She had elevated dehydroepiandrosterone sulfate, testosterone, and cortisol levels consistent with Cushing’s syndrome and hyperandrogenism. The patient eventually had a spontaneous abortion and elected to start chemotherapy and mitotane treatment. She passed away 3 months after initial presentation. Discussion: Adrenocortical carcinoma is difficult to detect and diagnose in pregnant patients because of the physiologic hormonal changes that take place during gestation. The patient described in this case report is an example of this diagnostic challenge. Conclusion: Adrenocortical carcinoma is a rare, fatal disease that often presents at an advanced stage with limited treatment options making earlier diagnosis imperative; however, diagnosis and treatment are complicated by pregnancy. More data is necessary to determine how best to approach these challenges in future patients. |
| Author | Marino, Michael John Markley Webster, Sara |
| Author_xml | – sequence: 1 givenname: Michael John surname: Marino fullname: Marino, Michael John email: michaelmari44@gmail.com organization: Department of Graduate Medical Education, Northside Hospital Gwinnett, Lawrenceville, Georgia – sequence: 2 givenname: Sara surname: Markley Webster fullname: Markley Webster, Sara organization: Division of Endocrinology, Department of Internal Medicine, Emory University School of Medicine, Atlanta, Georgia |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/37251968$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1530/EJE-10-0412 10.1186/s12884-020-2737-1 10.1210/jc.2005-2639 10.1056/NEJM199004263221705 10.1507/endocrj1954.35.685 10.1007/s00268-001-0047-y 10.1186/s12884-016-0915-y 10.4103/0970-1591.128507 10.1210/er.2013-1029 10.1210/jc.2010-2395 10.1016/0028-2243(89)90184-6 10.1007/s11102-015-0680-3 10.1007/s00268-005-0329-x 10.1210/jc.2004-2361 10.1016/j.beem.2008.10.008 10.1677/erc.1.01029 10.1210/jc.2015-2341 10.1177/1753495X13502958 10.1016/S0959-8049(98)00170-1 |
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| Keywords | adrenocortical carcinoma mitotane Cushing’s syndrome hyperandrogenism pregnancy |
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We present the case of a 28-year-old pregnant... Background/Objective: To describe a case highlighting a rare malignancy that can be camouflaged by the hormonal milieu of pregnancy. Case Report: We present... |
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| Title | Adrenocortical Carcinoma With Cushing’s Syndrome and Hyperandrogenism in a 28-Year-Old Pregnant Female |
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