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Mixed Corticomedullary Tumor Accompanied by Unilateral Aldosterone-Producing Adrenocortical Micronodules: A Case Report

Authors
  • Yoshida, Sawa1
  • Babaya, Naru1
  • Ito, Hiroyuki1
  • Hiromine, Yoshihisa1
  • Taketomo, Yasunori1
  • Niwano, Fumimaru1
  • Imamura, Shuzo1
  • Yamazaki, Yuto2
  • Sasano, Hironobu2
  • Kawabata, Yumiko1
  • Noso, Shinsuke1
  • Ikegami, Hiroshi1
  • 1 Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine, Osaka 589-8511 , (Japan)
  • 2 Department of Pathology, Tohoku University Graduate School of Medicine, Miyagi 980-8575 , (Japan)
Type
Published Article
Journal
Journal of the Endocrine Society
Publisher
The Endocrine Society
Publication Date
Aug 21, 2021
Volume
5
Issue
10
Identifiers
DOI: 10.1210/jendso/bvab140
PMID: 34514278
PMCID: PMC8415316
Source
PubMed Central
Keywords
Disciplines
  • AcademicSubjects/MED00250
License
Unknown

Abstract

Mixed corticomedullary tumors (MCMTs) are rare and comprise medullary and cortical cells in a single adrenal tumor. The mechanisms underlying their development have not been fully elucidated. Here, we report a case of MCMT in a 42-year-old woman. Based on the preoperative clinical findings, the patient was diagnosed as having a pheochromocytoma with subclinical Cushing syndrome. Postoperative pathological diagnosis revealed that the tumor demonstrated morphologically distinct medullary and cortical components, which produced catecholamines and cortisol, respectively. Hybrid tumor cells producing both catecholamines and cortisol were not detected. Adrenocorticotropin (ACTH)-positive tumor cells were identified to be present in the pheochromocytoma. This ectopic production of ACTH can contribute to an autonomous cortisol production in a paracrine manner. In addition, micronodules producing aldosterone were detected in the adrenal tissue adjacent to the tumor. The simultaneous development of these 2 lesions may not be correlated with each other; however, this case confirms the importance of a detailed histopathological examination of the adrenal lesions harboring complicated hormonal abnormalities by providing pivotal and indispensable information on their pathogenesis and the possible interaction of the hormones produced in the adrenal gland.

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