Frontiers in Endocrinology (Feb 2022)

Adrenal Hemorrhage in a Cortisol-Secreting Adenoma Caused by Antiphospholipid Syndrome Revealed by Clinical and Pathological Investigations: A Case Report

  • Kentaro Ochi,
  • Ichiro Abe,
  • Ichiro Abe,
  • Yuto Yamazaki,
  • Mai Nagata,
  • Yuki Senda,
  • Kaori Takeshita,
  • Midori Koga,
  • Yuka Yamao,
  • Toru Shigeoka,
  • Tadachika Kudo,
  • Yuichiro Fukuhara,
  • Shigero Miyajima,
  • Hiroshi Taira,
  • Shoji Haraoka,
  • Tatsu Ishii,
  • Yuichi Takashi,
  • Alfred K. Lam,
  • Hironobu Sasano,
  • Kunihisa Kobayashi

DOI
https://doi.org/10.3389/fendo.2021.769450
Journal volume & issue
Vol. 12

Abstract

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Due to its rarity, adrenal hemorrhage is difficult to diagnose, and its precise etiology has remained unknown. One of the pivotal mechanisms of adrenal hemorrhage is the thrombosis of the adrenal vein, which could be due to thrombophilia. However, detailed pathological evaluation of resected adrenal glands is usually required for definitive diagnosis. Here, we report a case of a cortisol-secreting adenoma with concomitant foci of hemorrhage due to antiphospholipid syndrome diagnosed both clinically and pathologically. In addition, the tumor in this case was pathologically diagnosed as cortisol-secreting adenoma, although the patient did not necessarily fulfill the clinical diagnostic criteria of full-blown Cushing or sub-clinical Cushing syndrome during the clinical course, which also did highlight the importance of detailed histopathological investigations of resected adrenocortical lesions.

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