Enfermedad de Cushing recurrente con hipercortisolismo catastrófico: Reporte de caso y revisión de literatura

Magdalena Otazú; Nicolás Tarigo; Andrés Salom; Ramiro Lima; Leandro Ricagni; Mercedes Piñeyro

doi:10.29193/RMU.38.3.13

Authors

Magdalena Otazú Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Clínica de Endocrinología y Metabolismo
Nicolás Tarigo Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Clínica Quirúrgica F, Prof. Adj.
Andrés Salom Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Clínica Quirúrgica F, Prof. Agdo.
Ramiro Lima Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Neurocirugía, Prof. Agdo.
Leandro Ricagni Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Cátedra Oncología Radioterápica
Mercedes Piñeyro Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Clínica de Endocrinología y Metabolismo, Prof. Agda.

DOI:

https://doi.org/10.29193/RMU.38.3.13

Keywords:

CUSHING’S SYNDROME, BILATERAL ADRENALECTOMY, CATASTROPHIC CUSHINGS

Abstract

The study presents the case of a 27-year-old female patient with adrenocorticotropic hormone (ACTH) dependent Cushing’s disease and severe hypercortisolism caused by recurrent pituitary macroadenoma that was resistant to treatment despite two transsphenoidal surgeries, radiotherapy and medical treatment. Upon failure of the different therapies a bilateral adrenalectomy was performed as the final treatment. The patient died in after surgery although the case of death was not clear.
Despite bilateral adrenalectomy having been reports as an effective treatment in patients with Cushing’s disease, it has been related to significant mortality rates in connection with the severity of hypercortisolism and existing comorbilities. In this case the left adrenalectomy ended up being an open surgery, which is associated to a higher mortality rate.

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