A 48-year-old woman with a 10-year history of hypertension, diabetes mellitus, and obesity presents with severe fatigue and bruising. Laboratory studies show cortisol 28 µg/dL, ACTH 8 pg/mL, and a 1 mg dexamethasone suppression test cortisol of 22 µg/dL. Abdominal CT shows a 3.5-cm right adrenal mass. Which of the following is the most likely diagnosis?
- A)Adrenal insufficiency with secondary hypertension
- B)Primary aldosteronism with metabolic syndrome
- C)ACTH-secreting pituitary adenoma
- D)Ectopic ACTH from carcinoid tumor
- E)ACTH-independent Cushing syndrome from adrenal adenomaGABARITO
Explicação
ACTH-independent Cushing syndrome from adrenal adenoma presents with elevated cortisol, suppressed ACTH (autonomous production), failure to suppress cortisol with dexamethasone (due to loss of feedback regulation), and a unilateral adrenal mass. The suppressed... Ver explicação completa e trilha adaptativa →