CC BY-NC-ND 4.0 · Revista Urología Colombiana / Colombian Urology Journal 2018; 27(02): 181-186
DOI: 10.1016/j.uroco.2017.03.011
Case Report | Caso Clínico
Sociedad Colombiana de Urología. Publicado por Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Adenoma adrenocortical ectópico parahiliar renal, en paciente con síndrome de Cushing independiente de ACTH. Abordaje laparoscópico. Reporte de caso y revisión de la literatura

Adrenocortical ectopic adenoma in a patient with ACTH independent Cushing's syndrome. Laparoscopic approach. Case report and review of literature
Carlos Eduardo Hernández
1   Urólogo, Unidad de Urología, Clínica Nogales, Bogotá, Colombia
,
José Gustavo Ramos Ulloa
2   Urólogo, Pontificia Universidad Javeriana, Bogotá, Colombia
,
Sara Rocío Peralta Pizza
3   Médica y cirujana, Pontificia Universidad Javeriana, Bogotá, Colombia
,
Mauricio Moreno
4   Urólogo, Unidad de Urología, Hospital de la Policía, Bogotá, Colombia
› Author Affiliations
Further Information

Publication History

20 December 2016

25 March 2017

Publication Date:
10 January 2018 (online)

Resumen

Objetivos El adenoma adrenocortical ectópico es el producto de la transformación de tejido adrenal ectópico embriológico en adenoma funcionante. Su asociación con síndrome de Cushing corresponde a menos del 2% de los casos. El presente es el noveno caso reportado en la literatura, por lo tanto se pretende recalcar la manera de realizar un adecuado abordaje diagnóstico multidisciplinario logrando el enfoque quirúrgico que permite el mejor tratamiento.

Materiales y métodos Búsqueda en bases de datos Pubmed, Lilacs, Embase. Revisión de la historia clínica y seguimiento postoperatorio.

Resultados Paciente femenina de 28 años quien presentó un aborto en primer trimestre de embarazo, asociado a hipertensión arterial, facies de luna llena y obesidad centrípeta. Se encuentra masa pararrenal izquierda. Se realiza abordaje laparoscópico para la resección de la misma, con patología que informa adenoma cortical adrenal. Resolución de sintomatología después del procedimiento.

Conclusiones Es un caso de baja frecuencia, donde es importante identificar la sintomatología temprana, así como realizar un abordaje multidisciplinario con el fin de realizar un correcto abordaje diagnóstico y terapéutico.

Abstract

Objectives Ectopic adrenocortical adenoma is the result of the transformation of adrenal ectopic tissue in functional adenoma. It is associated with Cushing's syndrome is less than 2% of cases. The case presented here is the 9th reported in literature. Emphasis is placed on a comprehensive multidisciplinary diagnostic approach with a surgical focus that leads to a better management.

Materials and methods Review of literature in PubMed, Lilacs, and Embase. Review of the clinical records and post-surgical follow-up of the patient.

Results The patient is a 28 year-old female who had a spontaneous abortion in the first-trimester that was associated with high blood pressure, moon face and centripetal obesity. A left para-renal mass was found, and a laparoscopic resection was performed on the tumour. The histopathology showed that it was an adrenal cortical adenoma. The symptoms resolved after the procedure.

Conclusions Although this is a rare case, it is important to identify early symptoms, using a multidisciplinary approach in order to make a correct diagnosis and its early management.

 
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