Bilateral macronodular adrenal hyperplasia (BMAH) is a rare cause of Cushing syndrome that is marked by an enlarged adrenal gland with numerous nodules that are greater than 10 mm in diameter and can exceed 30-40 mm in diameter. Many recent studies have suggested that hypercortisolism in BMAH is caused by ectopic hormone receptor expression, such as gastric inhibitory polypeptide, vasopressin, or catecholamine, or by overexpression of eutopic receptor on the adrenal glands. BMAH is also affected by multiple somatic gene mutations during embryogenesis and inherited germline mutations, according to genetic studies. A 54-year-old man with Cushing syndrome caused by BMAH and a negative response to an aberrant hormone receptor test is defined. We performed a laparoscopic adrenalectomy on both sides. After the procedure, both leg edoema and serum cortisol levels returned to normal.
Author (s) DetailsSeong Min Hong
Division of Endocrinology & Metabolism, Department of Internal Medicine, College of Medicine, Inje University, Busan, Korea
Soon Hee Lee
Division of Endocrinology & Metabolism, Department of Internal Medicine, College of Medicine, Inje University, Busan, Korea
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