A 17-year-old male was admitted with the complaint of progressive weight gain. Abdominal ultrasonography was performed for elevation in transaminases which revealed a hypoechoic mass located in the left adrenal gland. [ncbi.nlm.nih.gov]

“Most of the time the answer is no, but other times the gland starts making excess hormones, which can lead to high blood pressure, weight gain, diabetes or glucose intolerance — in which case, treatment is indicated.” [nydailynews.com]

Symptoms of too much cortisol can include: Weight loss or weight gain (especially around the face and abdomen) Purplish skin stretch marks or skin that’s easily bruised Acne Muscle weakness Depression, anxiety, fatigue, and sleep disturbances In women [hormone.org]

Weight gain? Diabetes? Infertility? Patients with cortisol excess may also present with easy bruising, poor wound healing, weakness, new acne or excessive facial hair growth. Note, often cortisol-secreting adenomas are subclinical. [clinicaladvisor.com]

Patients with adrenal incidentaloma reported reduced QoL and a higher level of physical fatigue compared to age- and sex-matched controls. [ncbi.nlm.nih.gov]

Alpha-blockade with phenoxybenzamine 10mg daily, titrated to 10mg tds over 3weeks. - then lap adrenalectomy - side effects are orthostatic hypotension, fatigue and sinus congestion. - beta-blockade not recommended unless tachycardic. 2. [gog.net.nz]

Symptoms of too much cortisol can include: Weight loss or weight gain (especially around the face and abdomen) Purplish skin stretch marks or skin that’s easily bruised Acne Muscle weakness Depression, anxiety, fatigue, and sleep disturbances In women [hormone.org]

Non-specific, fatigue and generalized weakness are frequent complaints. Finally, neuropsychiatric symptoms have been reported, with depression and lethargy being the most common. [clinicaladvisor.com]

Even without Cushingoid features in pituitary incidentaloma, we concluded that the elevated ACTH and cortisol levels should be followed up by CRH, desmopressin and dexamethasone suppression tests. [ncbi.nlm.nih.gov]

severe or paroxysmal hypertension, frank hypokalemia, Cushingoid features, or referral from another hospital for adrenal examination, n 93); 2) adrenal tumor smaller than 1.0 cm (n 13); 3) adrenal thickening or hyperplasia (n 32); or 4) missing baseline [kjim.org]

CONCLUSIONS: Familial adenomatous polyposis-associated adrenal incidentaloma may warrant long-term follow-up. [ncbi.nlm.nih.gov]

Marchesa P, Fazio VW, Church JM, McGannon E. adrenal masses in patients with familial adenomatous polyposis. Dis Colon Rectum 1997;40:1023–1028. 7. Gross MD, Shapiro B. Clinical review 50: clinically silent adrenal masses. [synapse.koreamed.org]

Berliner L, Bosniak MA, Megibow A: Adrenal pseudotumors on computed tomography. J Comput Assist Tomogr 1982;6:281–285. PubMed CrossRef Google Scholar (8). [link.springer.com]

Patients with cortisol excess may also present with easy bruising, poor wound healing, weakness, new acne or excessive facial hair growth. Note, often cortisol-secreting adenomas are subclinical. [clinicaladvisor.com]

bruising, poor wound-healing, emotional and cognitive changes Hypertension Hyperglycaemia Hyperlipidaemia Osteoporosis 1 mg overnight dexamethasone suppression test 8 mg dexamethasone suppression test Midnight salivary cortisol Conn’s syndrome Mostly [racgp.org.au]

About 2 h after taking the second dose of 2 mg dexamethasone, she suddenly developed nausea and vomiting, palpitations, and anxiety with severe hypertension. On the same day, we measured serum catecholamines, which were markedly elevated. [ncbi.nlm.nih.gov]

Clinical clues include nausea, abdominal pain, fever, and diarrhea. Terzolo M, Bovio S, Pia A, Reimondo G, Angeli A. Management of adrenal incidentaloma. Best Pract Res Clin Endocrinol Metab. 2009 Apr. 23(2):233-43. [Medline]. [emedicine.medscape.com]

Nausea and vomiting were associated. Physical examination was unremarkable. No other abnormalities e. g hypertension, diabetes mellitus, headache could be detected after examination of the patient & subsequent investigations. [ispub.com]

Medical therapy consists of spironolactone, but side effects such as painful gynecomastia, nausea and headache can lead to poor compliance. Eplerenone may be more tolerable for many patients but may be somewhat less effective. E. [clinicaladvisor.com]

Adrenal incidentaloma is not infrequent and can be found in hirsute women. [ncbi.nlm.nih.gov]

hirsutism temporal balding voice changes clitoral enlargement acne increased muscle mass decreased breast size amenorrhea 23 Before we proceed……. chromaffin 1.The medulla is composed of ____________ cells derived from the_____________. neural crest. 2 [slideplayer.com]

presented in 1995y. (23y.) as severe hirsutism and infertility managed by team of gynecologists. She refused any additional investigations and was severily depressed. Ex iuvantibus 0.5mg dexamethason therapy was followed with pregnancy. [endocrine-abstracts.org]

[…] ambulatory Cannot be done if patient is on aldosterone antagonist If patient is on ACEi/ARB, renin typically elevated, so low ratio may be inaccurate, but high ratio (i.e. low renin) strongly suggests diagnosis Pheochromocytoma: Symptoms: palpitations, headache [errolozdalga.com]

Signs of pheochromocytoma: Patients should be asked about headache, palpitations, panic attacks, orthostasis, tremulousness, flushing or pallor, and constipation. [clinicaladvisor.com]

Symptoms of too much norepinephrine or epinephrine can include: Fast or irregular heartbeat Sweating Severe headaches Shakiness Pale face High blood pressure. [hormone.org]

CASE REPORT: A 48 yrs old female presented with complaints of intermittent, dull aching, vague abdominal pain for the past one year.Nohistory of abdomen distention, burning micturition, fever, vomiting,gastrointestinal bleeding, headache, sweating, palpitation [ijbms.com]

node hyperplasia (Castleman’s disease) of the hyaline-vascular type. [karger.com]