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Ciftci S, Soyluk O, Selek A, Erol S, Hekimsoy Z, Esen A, Dursun H, Sahin S, Oruk G, Mert M, Soylu H, Yurekli BS, Ertorer ME, Omma T, Evran M, Adas M, Tanrikulu S, Aydin K, Pekkolay Z, Can B, Karakilic E, Karaca Z, Bilen H, Canturk Z, Cetinarslan B, Kadioglu P, Yarman S. The Importance of DHEA-S Levels in Cushing's Syndrome; Is There a Cut-off Value in the Differential Diagnosis? Horm Metab Res 2022; 54:232-237. [PMID: 35413744 DOI: 10.1055/a-1783-7901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purpose of this study was to determine possible cut-off levels of basal DHEA-S percentile rank in the differential diagnosis of patients with Cushing's syndrome (CS) with ACTH levels in the gray zone and normal DHEA-S levels. In this retrospective study including 623 pathologically confirmed CS, the DHEA-S percentile rank was calculated in 389 patients with DHEA-S levels within reference interval. The patients were classified as group 1 (n=265 Cushing's disease; CD), group 2 (n=104 adrenal CS) and group 3 (n=20 ectopic ACTH syndrome).ROC-curve analyses were used to calculate the optimal cut-off level of DHEA-S percentile rank in the reference interval in the differential diagnosis of CS, and the effectiveness of this cut-off level in the identification of the accurate etiology of CS was assessed in patients who were in gray zone according to their ACTH levels. The DHEA-S percentile rank in the reference interval were significantly lower in group 2 compared to the other two groups (p<0.001), while group 1 and group 3 had similar levels. The optimal cut-off level of DHEA-S percentile rank in the reference interval providing differential diagnosis between group 1 and group 2 was calculated as 19.5th percentile (80.8% sensitivity, 81.5% specificity) and the level demonstrated the accurate etiology in 100% of CD and 76% of adrenal CS patients who were in the gray zone. This study showed that the cut-off value of DHEA-S level less than 20% of the reference interval could be used for differential diagnosis of CD and adrenal CS with high sensitivity and specificity, and it should be taken into the initial evaluation.
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Affiliation(s)
- Sema Ciftci
- Department of Endocrinology and Metabolsim, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ozlem Soyluk
- Department of Endocrinology and Metabolism, Istanbul University, Fatih, Turkey
| | - Alev Selek
- Department of Endocrinology and Metabolism, Kocaeli University, Kocaeli, Turkey
| | - Selvinaz Erol
- Department of Endocrinology and Metabolism, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | | | - Ayse Esen
- Department of Endocrinology and Metabolsim, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Huseyin Dursun
- Department of Endocrinology and Meatbolism, Erciyes University School of Medicine, Kayseri, Turkey
| | - Serdar Sahin
- Department of Endocrinology and Metabolism, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Gonca Oruk
- Department of Endocrinology and Metabolism, Izmir Ataturk Training and Research Hospital, Izmir, Turkey
| | - Meral Mert
- Department of Endocrinology and Metabolsim, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Huseyin Soylu
- Department of Endocrinology and Metabolism, Ondokuz Mayis University, School of Medicine, Samsun, Turkey
| | - Banu Sarer Yurekli
- Department of Endocrinology and Metabolism, Ege University Faculty of Medicine, Izmir, Turkey
| | - Melek Eda Ertorer
- Department of Endocrinology and Metabolism, Baskent University Faculty of Medicine, Adana, Turkey
| | - Tulay Omma
- Department of Endocrinology and Metabolism, Ankara Training and Research Hospital, Ankara, Turkey
| | - Mehtap Evran
- Department of Endocrinology and Metabolism, Çukurova University Medical Faculty, Adana, Turkey
| | - Mine Adas
- Department of Endocrinology and Metabolism, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Seher Tanrikulu
- Department of Endocrinology and Metabolsim, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | - Kadriye Aydin
- Department of Endocrinology and Metabolism, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Zafer Pekkolay
- Department of Endocrinology and Metabolism, Dicle Faculty of Medicine, Diyarbakır, Turkey
| | - Bülent Can
- Department of Endocrinology and Metabolism, Istanbul Medeniyet University Faculty of Medicine, İstanbul, Turkey
| | - Ersen Karakilic
- Department of Endocrinology and Metabolism, Canakkale Onsekiz Mart University Medical Faculty, Çanakkale, Turkey
| | - Zuleyha Karaca
- Department of Endocrinology and Meatbolism, Erciyes University School of Medicine, Kayseri, Turkey
| | - Habib Bilen
- Department of Endocrinology and Metabolism, Ataturk University Faculty of Medicine, Ezurum, Turkey
| | - Zeynep Canturk
- Department of Endocrinology and Metabolism, Kocaeli University, Kocaeli, Turkey
| | - Berrin Cetinarslan
- Department of Endocrinology and Metabolism, Kocaeli University, Kocaeli, Turkey
| | - Pinar Kadioglu
- Department of Endocrinology and Metabolism, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Sema Yarman
- Department of Endocrinology and Metabolism, Istanbul University, Fatih, Turkey
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Dogansen SC, Cikrikcili U, Oruk G, Kutbay NO, Tanrikulu S, Hekimsoy Z, Hadzalic A, Gorar S, Omma T, Mert M, Akbaba G, Yalin GY, Bayram F, Ozkan M, Yarman S. Dopamine Agonist-Induced Impulse Control Disorders in Patients With Prolactinoma: A Cross-Sectional Multicenter Study. J Clin Endocrinol Metab 2019; 104:2527-2534. [PMID: 30848825 DOI: 10.1210/jc.2018-02202] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 03/04/2019] [Indexed: 11/19/2022]
Abstract
CONTEXT Dopamine agonist (DA)-induced impulse control disorder (ICD) in patients with prolactinomas is not sufficiently known. OBJECTIVE To evaluate the prevalence of DA-induced ICDs and possible risk factors related to these disorders in patients with prolactinoma. DESIGN, SETTING, AND PARTICIPANTS This is a cross-sectional multicenter study involving 308 patients with prolactinoma followed up in tertiary referral centers who received at least three months of DA therapy. DA-induced ICDs (pathological gambling, hypersexuality, compulsive shopping, and compulsive eating) and impulsivity were assessed using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson Disease and the Barratt Impulsiveness Scale-11, respectively. Patients were evaluated in terms of parameters related to ICD development. RESULTS Any ICD prevalence was 17% (n = 51). Hypersexuality was most common (6.5%). Although any ICD and hypersexuality were more common in male patients (P = 0.009, P < 0.001, respectively), compulsive eating was more common in female patients (P = 0.046). Current smoking, alcohol use, and gambling history were more frequent (P = 0.033, P = 0.002, P = 0.008, respectively) in patients with any ICD. In Barratt Impulsiveness Scale-11 total, attentional, motor, and nonplanning scores were higher in patients with any ICD (P < 0.001). Current smoking and alcohol use were more frequent (P = 0.007, P = 0.003, respectively) and percentage increase of testosterone levels at last visit was higher (P = 0.021) in male patients with prolactinomas with hypersexuality. CONCLUSION Any ICD may be seen in one of six patients with prolactinoma who are receiving DA therapy. Endocrinology specialists should be aware of this side effect, particularly in male patients with a history of gambling, smoking, or alcohol use.
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Affiliation(s)
- Sema Ciftci Dogansen
- Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul University, Istanbul, Turkey
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ugur Cikrikcili
- Istanbul Faculty of Medicine, Department of Psychiatry, Istanbul University Istanbul, Turkey
| | - Gonca Oruk
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Izmir Ataturk Training and Research Hospital, Izmir, Turkey
| | - Nilufer Ozdemir Kutbay
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Seher Tanrikulu
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Zeliha Hekimsoy
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Celal Bayar University Medicine Faculty, Manisa, Turkey
| | - Aysa Hadzalic
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Erciyes University School of Medicine, Kayseri, Turkey
| | - Suheyla Gorar
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Antalya Training and Research Hospital, Antalya, Turkey
| | - Tulay Omma
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara Training and Research Hospital, Ankara, Turkey
| | - Meral Mert
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Gulhan Akbaba
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Mugla Sıtkı Kocman University School of Medicine, Mugla, Turkey
| | - Gulsah Yenidunya Yalin
- Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul University, Istanbul, Turkey
| | - Fahri Bayram
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Erciyes University School of Medicine, Kayseri, Turkey
| | - Mine Ozkan
- Istanbul Faculty of Medicine, Department of Psychiatry, Istanbul University Istanbul, Turkey
| | - Sema Yarman
- Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul University, Istanbul, Turkey
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Özdemirkıran F, Oruk G, Payzin B, Gümüş Z, Koruyucu M, Atasever T, Küçükzeybek B, Esen Ö. Rapidly Growing Thyroid Mass: An Unusual Case of Acute Lymphoblastic Leukemia. Turk J Haematol 2015; 32:276-8. [PMID: 26376596 PMCID: PMC4563207 DOI: 10.4274/tjh.2015.0136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Füsun Özdemirkıran
- Katip Çelebi University Faculty of Medicine, Atatürk Training and Research Hospital, Clinic of Hematology,
İzmir, Turkey E-mail:
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Tanriverdi F, Dokmetas HS, Kebapcı N, Kilicli F, Atmaca H, Yarman S, Ertorer ME, Erturk E, Bayram F, Tugrul A, Culha C, Cakir M, Mert M, Aydin H, Taskale M, Ersoz N, Canturk Z, Anaforoglu I, Ozkaya M, Oruk G, Hekimsoy Z, Kelestimur F, Erbas T. Etiology of hypopituitarism in tertiary care institutions in Turkish population: analysis of 773 patients from Pituitary Study Group database. Endocrine 2014; 47:198-205. [PMID: 24366641 DOI: 10.1007/s12020-013-0127-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 11/13/2013] [Indexed: 02/02/2023]
Abstract
Hypopituitarism in adult life is commonly acquired and the main causes are known as pituitary tumors and/or their treatments. Since there are new insights into the etiology of hypopituitarism and presence of differences in various populations, more studies regarding causes of hypopituitarism are needed to be done in different ethnic groups with sufficient number of patients. Therefore, we performed a multi-center database study in Turkish population investigating the etiology of hypopituitarism in 773 patients in tertiary care institutions. The study was designed and coordinated by the Pituitary Study Group of SEMT (The Society of Endocrinology and Metabolism of Turkey). Nineteen tertiary reference centers (14 university hospitals and 5 training hospitals) from the different regions of Turkey participated in the study. It is a cross-sectional database study, and the data were recorded for 18 months. We mainly classified the causes of hypopituitarism as pituitary tumors (due to direct effects of the pituitary tumors and/or their treatments), extra-pituitary tumors and non-tumoral causes. Mean age of 773 patients (49.8 % male, 50.2 % female) was 43.9 ± 16.1 years (range 16-84 years). The most common etiology of pituitary dysfunction was due to non-tumoral causes (49.2 %) among all patients. However, when we analyze the causes according to gender, the most common etiology in males was pituitary tumors, but the most common etiology in females was non-tumoral causes. According to the subgroup analysis of the causes of hypopituitarism in all patients, the most common four causes of hypopituitarism which have frequencies over 10 % were as follows: non-secretory pituitary adenomas, Sheehan's syndrome, lactotroph adenomas and idiopathic. With regard to the type of hormonal deficiencies; FSH/LH deficiency was the most common hormonal deficit (84.9 % of the patients). In 33.8 % of the patients, 4 anterior pituitary hormone deficiencies (FSH/LH, ACTH, TSH, and GH) were present. Among all patients, the most frequent cause of hypopituitarism was non-secretory pituitary adenomas. However, in female patients, present study clearly demonstrates that Sheehan's syndrome is still one of the most important causes of hypopituitarism in Turkish population. Further, population-based prospective studies need to be done to understand the prevalence and incidence of the causes of hypopituitarism in different countries.
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Affiliation(s)
- F Tanriverdi
- Department of Endocrinology, Erciyes University Medical School, 38039, Kayseri, Turkey,
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Gorgel A, Cetinkaya DD, Salgur F, Demirpence M, Yilmaz H, Karaman EH, Tutuncuoglu P, Oruk G, Bahceci M, Sari AA, Altinboga AA, Paker I. Coexistence of gastrointestinal stromal tumors (GISTs) and pheochromocytoma in three cases of neurofibromatosis type 1 (NF1) with a review of the literature. Intern Med 2014; 53:1783-9. [PMID: 25130111 DOI: 10.2169/internalmedicine.53.2012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
It is well known that neurofibromatosis type 1 (NF1) is uncommonly associated with pheochromocytoma development and also, to a larger extent, with gastrointestinal stromal tumors (GISTs). We herein document three cases with the rare condition of NF1 coexisting with GIST and pheochromocytoma, while one of them also has a composite tumor and another has papillary thyroid carcinoma.
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Affiliation(s)
- Ahmet Gorgel
- Department of Endocrinology and Metabolism, Ataturk Training and Research Hospital, Turkey
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Bahceci M, Dolek D, Tutuncuoglu P, Gorgel A, Oruk G, Yenen I. A case series of Bardet-Biedl syndrome in a large Turkish family and review of the literature. Eat Weight Disord 2012; 17:e66-9. [PMID: 22751275 DOI: 10.1007/bf03325331] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND AIM Bardet-Biedl syndrome (BBS) is a rare autosomal recessive genetic disorder. We aimed to report a case series of Bardet-Biedl syndrome in a Turkish family and review the literature. PATIENTS AND METHODS This family had 3 females and 4 males, totally 7 alive; 2 children (1 female and 1 male) had died. Parents were consanguineous. The first was a birth of twins and female sibling of these twins had congenital anal atresia and died when she was three-month old. Third (30 yr), 4th (28 yr) and 9th (19 yr) alive siblings were obese, blind and diabetic. We detected truncal obesity, postaxial polydactyly, cognitive impairment and hypogonadism. Rod-cone dystrophy was detected in ophthalmic examination. With these typical clinical findings, BBS was diagnosed. There was also a male member of the family which shared the same features of his affected brothers but he had died while he was eight months old. Marked glycosuria was determined and urine density was 1021 g/cm3. There was not any further endocrinological abnormality. Fasting blood glucose levels were changing between 290 and 452 mg/dl and the last glycated hemoglobine levels (A1c) were 9.3%, 11.2% and 12.8%, respectively. Diabetes mellitus and obesity were treated with diet, exercise, multiple daily insulin injections and metformine at the dose of 2000 mg/d. CONCLUSIONS Although it is an infrequent condition due to autosomal recessive transmission, consanguineous marriage may increase the risk of emergence of BBS. Genetic counseling is a very important issue in the family of patients with BBS, in order to prevent new cases.
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Affiliation(s)
- M Bahceci
- Department of Endocrionology and Metabolism, Atatürk Training and Research Hospital, Izmir, Turkey.
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Abstract
OBJECTIVE To report the fifth case of multiglandular parathyroid carcinoma and highlight the necessity of bilateral neck exploration in some circumstances. METHODS We report a case of simultaneous bilateral and multiglandular parathyroid carcinoma in a 48-year-old woman presenting with primary hyperparathyroidism. Ultrasonography revealed a 24- by 24- by 34-mm nodule on the right lobe of the thyroid and a 20- by 20- by 32-mm parathyroid gland inferior to the left thyroid lobe. Technetium Tc 99m sestamibi scan revealed bilateral increased uptake consistent with the parathyroid glands. She was treated with bilateral neck exploration and parathyroidectomy with en bloc resection of the adjacent thyroid lobe in the right lower gland and parathyroidectomy with resection of surrounding soft tissue in the left lower gland. RESULTS The presence of a thick fibrous capsule, invasion of surrounding tissues, trabecular and solid growth pattern without necrotic foci, and vascular invasion on pathology slides enabled the diagnosis of parathyroid carcinoma of both glands. Her calcium and parathyroid hormone levels were within normal limits during a follow-up period of 4 years. CONCLUSION Since surgical resection offers the only curative treatment and initial operation may be the determinant of survival, a high index of suspicion for carcinoma both clinically and intraoperatively is vital. We aim to reemphasize that bilateral neck exploration in select cases of parathyroid carcinoma should be considered if there is concrete evidence of a second tumor, since parathyroid carcinoma can coexist with hyperplasia, adenoma, or even carcinoma of other parathyroid glands.
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Affiliation(s)
- Mehmet Haciyanli
- Department of 2nd General Surgery, Ataturk Training and Research Hospital, Izmir, Turkey.
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Haciyanli M, Genc H, Damburaci N, Oruk G, Tutuncuoglu P, Erdogan N. Minimally invasive focused parathyroidectomy without using intraoperative parathyroid hormone monitoring or gamma probe. J Postgrad Med 2010; 55:242-6. [PMID: 20083868 DOI: 10.4103/0022-3859.58925] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Minimally invasive parathyroidectomy (MIP) is widely used worldwide for the treatment of primary hyperparathyroidism (pHPT). It is usually combined with a perioperative adjunct for high success rate. AIM To demonstrate that MIP can be successfully performed in a selected group of patients with presumabally solitary adenoma as the cause of pHPT without using any perioperative adjuncts. SETTINGS AND DESIGN A prospective data analysis of two surgeons' series from a teaching hospital in Turkey. MATERIALS AND METHODS Of the 47 patients referred with a diagnosis of pHPT during January 2004-May 2008, 30(63%) patients with sporadic pHPT with presumed solitary adenoma were included for analysis. These patients underwent MIP via focused lateral (n=24) or anterior (n=6) approach. Preoperative localization was done using 99 mTc-labelled sestamibi scan and ultrasonography. Only patients with concordant tests for single adenoma were selected for MIP. Serum parathyroid hormone and calcium levels were measured postoperatively and at follow-up visits. STATISTICAL ANALYSIS Parametric data presented were analyzed with Excel XP (Microsoft, Redmond, WA, USA). RESULTS Barring one patient, all other patients were initially biochemically cured by MIP. One patient remained hypercalcemic, who was found to have a second adenoma at the second operation. During a mean follow-up of 16 (3-55) months, all patients were normocalcemic with a mean serum calcium level of 9.4 (8.9-10.2) mg/dl. Parathormone levels were persistantly elevated only in one patient (3.4%). No postoperative permanent complication was encountered. CONCLUSION The results of MIP achieved in high-volume endocrine surgery centers can be replicated in low-volume center without any intraoperative adjuncts, in patients with overt clinical pHPT and concordant results of sestamibi and ultrasound.
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Affiliation(s)
- M Haciyanli
- Ataturk Training and Research Hospital, Second Surgery, Izmir, Turkey
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Kabayegit OY, Soysal D, Oruk G, Ustaoglu B, Kosan U, Solmaz S, Avci A. Adrenocortical oncocytic neoplasm presenting with Cushing's syndrome: a case report. J Med Case Rep 2008; 2:228. [PMID: 18620603 PMCID: PMC2481265 DOI: 10.1186/1752-1947-2-228] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Accepted: 07/13/2008] [Indexed: 11/29/2022] Open
Abstract
Introduction Oncocytic neoplasms occur in several organs and are most commonly found in the thyroid, kidneys and salivary glands. Oncocytic neoplasms of the adrenal cortex are extremely rare and are usually non-functioning. Case presentation We report the case of an adrenocortical oncocytic neoplasm with uncertain malignant potential in a 31-year-old man with Cushing's syndrome. The patient had been operated on following diagnosis of a 7 cm adrenal mass. Following surgery, the Cushing's syndrome resolved. The patient is still alive with no metastases one year after the surgery. Conclusion Adrenocortical oncocytic neoplasms must be considered in the differential diagnosis of both functioning and non-functioning adrenal masses.
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Oz B, Olmez N, Memis A, Oruk G. Differential Diagnosis of Polyuria and Polydipsia in a Patient with Spinal Cord Injury. Am J Phys Med Rehabil 2005; 84:817-20. [PMID: 16205438 DOI: 10.1097/01.phm.0000179515.25335.af] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report the case of a 35-yr-old tetraplegic man who experienced increased water intake, constant thirst, and a copious amount of urine excretion after his spinal cord injury and in whom an intermittent catheterization program was unmanageable. Laboratory evaluation revealed low serum and urine osmolality, which were suggestive of psychogenic polydipsia, and hypokalemia, which might lead to polyuria with a compensatory polydipsia. His water intake was reduced with antidepressant therapy and potassium supplementation and normalized on the third month of the treatment. Physicians should be aware of the differential diagnosis of polyuria and polydipsia, which interfere with neurogenic bladder management in patients with spinal cord injury.
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Affiliation(s)
- Bengi Oz
- Ataturk Training and Research Hospital, Izmir, Turkey
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