Adrenal incidentaloma. Presentation of a case

Abstract

64-years-old patient, white, female patient, refers the beginning of left lumbar abdominal pain three months before entering the hospital, accompanied with a progressive weight increase, a remarked appetite increase, facial flushing, debuting arterial hypertension and, later, hirsuteness. For that reason she assisted to her physician and he indicated an abdominal ultrasound, finding an ultrasonographic image compatible with left suprarenal tumor. The surgeon indicated an abdominal computed tomography confirming the tumor, tributary of surgery treatment because of its size. The surgery began as a laparoscopy, but they found a 12 cm suprarenal tumor mass, adhered to near organs, and it became an open surgery, and the splenectomy was also necessary. The postsurgery period lasted 72 hours with a few favorable evolution, associated general syndrome, hypopotasemy, pain in the place of surgical intervention. We made a new videolaparoscopic surgery without finding local complications. We decided to transfer the patient to the Intermediate Care Unit, valuing the possibility of her clinical status being secondary to a remarked deprivation of endogenous glucocorticoids for hyper functioning tumor of the cortex. From the moment she entered we began a substitutive treatment with Hydrocortisone 300 mg/day, achieving an evident clinical improvement in 72 hours. After 6 days in the Intermediate Care Unit, she was transferred to the Surgery Unit and discharged from the hospital.