A 67-year-old man with severe hypertension (BP 178/104 mmHg) and hypokalemia (K+ 2.8 mEq/L) undergoes evaluation. Morning cortisol is 42 mcg/dL (normal <20), ACTH is 8 pg/mL (normal 10-50), and aldosterone is elevated at 28 ng/dL with suppressed plasma renin. Low-dose dexamethasone suppression test does not suppress cortisol. Which of the following is the most likely diagnosis?
- A)Ectopic ACTH syndrome
- B)Primary hyperaldosteronism
- C)Glucocorticoid remediable hypertension
- D)Pituitary ACTH-secreting adenoma
- E)Adrenocortical carcinomaGABARITO
Explicação
Adrenocortical carcinoma presents with high cortisol, suppressed ACTH (autonomous production), and non-suppression at high-dose dexamethasone. Concurrent elevation of aldosterone (and hypokalemia) indicates a tumor secreting multiple steroid hormones, which is... Ver explicação completa e trilha adaptativa →