{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T03:32:48Z","timestamp":1771471968678,"version":"3.50.1"},"reference-count":17,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2016,11,15]]},"abstract":"<jats:p>Mixed corticomedullary adrenal tumours (MCMT) are rare. We describe the second reported case of a male patient presenting with hypertension and Cushing syndrome with MCMT. A man aged 48\u2005years presented with hypertension and signs of Cushing syndrome. 24-hour urine cortisol was elevated, with detectable adrenocorticotropic hormone (ACTH). A high-dose dexamethasone suppression test indicated an adrenal or ectopic Cushing syndrome. Plasma metanephrines were normal. A 3\u2005cm left adrenal mass was identified without potential ectopic sources of ACTH on imaging. After induction of anaesthesia for laparoscopic adrenalectomy, the patient developed resistant hypertension with stress-dose hydrocortisone administration. Surgery was cancelled and repeat testing revealed elevated plasma metanephrines. \u03b1-Blockade was administered for a presumed coexisting pheochromocytoma, and the patient underwent adrenalectomy. Pathology revealed an MCMT. This case highlights the importance of a thorough biochemical evaluation in patients with adrenal masses to rule out multiple hormone producing tumours.<\/jats:p>","DOI":"10.1136\/bcr-2016-216965","type":"journal-article","created":{"date-parts":[[2016,11,30]],"date-time":"2016-11-30T15:25:20Z","timestamp":1480519520000},"page":"bcr2016216965","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Adrenal Cushing syndrome with detectable ACTH from an unexpected source"],"prefix":"10.1136","volume":"2016","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1820-088X","authenticated-orcid":false,"given":"Thinzar M","family":"Lwin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nehal","family":"Galal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shweta","family":"Gera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer L","family":"Marti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,11,30]]},"reference":[{"key":"2025042705550462000_2016.nov30_1.bcr2016216965.1","doi-asserted-by":"publisher","DOI":"10.1053\/adpa.2001.28297"},{"key":"2025042705550462000_2016.nov30_1.bcr2016216965.2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(69)90193-4"},{"key":"2025042705550462000_2016.nov30_1.bcr2016216965.3","first-page":"659","article-title":"[A case of adrenal mixed tumor of pheochromocytoma and adrenocortical adenoma presenting diabetes mellitus and hypertension]","volume":"69","author":"Akai","year":"1993","journal-title":"Nihon Naibunpi Gakkai Zasshi"},{"key":"2025042705550462000_2016.nov30_1.bcr2016216965.4","first-page":"157","article-title":"Cortico-medullary mixed tumor (pheochromocytoma and cortical adenoma) of the adrenal gland","volume":"3","author":"Ohta","year":"1995","journal-title":"J Urol Pathol"},{"key":"2025042705550462000_2016.nov30_1.bcr2016216965.5","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1016\/S0344-0338(96)80023-9","article-title":"Corticomedullary tumors of the adrenal glands. Report of two cases. Association of corticomedullary tumor with spindle cell sarcoma","volume":"192","author":"Michal","year":"1996","journal-title":"Pathol Res Pract"},{"key":"2025042705550462000_2016.nov30_1.bcr2016216965.6","doi-asserted-by":"crossref","first-page":"e329","DOI":"10.5858\/2003-127-e329-CMTOTA","article-title":"Corticomedullary mixed tumor of the adrenal gland with concurrent adrenal myelolipoma","volume":"127","author":"Chu","year":"2003","journal-title":"Arch Pathol Lab Med"},{"key":"2025042705550462000_2016.nov30_1.bcr2016216965.7","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1097\/TEN.0b013e3181596219","article-title":"Coexistence of adrenal Cushing syndrome and pheochromocytoma in a \u2018corticomedullary adenoma\u2019: a case report and review of the literature","volume":"17","author":"Ma","year":"2007","journal-title":"Endocrinologist"},{"key":"2025042705550462000_2016.nov30_1.bcr2016216965.8","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1111\/j.1365-2265.2007.03038.x","article-title":"Phaeochromocytoma and mixed corticomedullary tumour\u2014a rare cause of Cushing's syndrome and labile hypertension in a primigravid woman postpartum","volume":"68","author":"Lee","year":"2008","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2025042705550462000_2016.nov30_1.bcr2016216965.9","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-2013"},{"key":"2025042705550462000_2016.nov30_1.bcr2016216965.10","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1507\/endocrj.K09E-010","article-title":"Corticomedullary mixed adrenal tumor: case report and literature review","volume":"56","author":"Alexandraki","year":"2009","journal-title":"Endocr J"},{"key":"2025042705550462000_2016.nov30_1.bcr2016216965.11","doi-asserted-by":"crossref","first-page":"589","DOI":"10.3109\/00313025.2010.508741","article-title":"Mixed corticomedullary tumour with myelolipoma: a rare coexistence","volume":"42","author":"Singh","year":"2010","journal-title":"Pathology"},{"key":"2025042705550462000_2016.nov30_1.bcr2016216965.12","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.anndiagpath.2010.02.005","article-title":"Mixed cortical adenoma and composite pheochromocytoma-ganglioneuroma: an unusual corticomedullary tumor of the adrenal gland","volume":"15","author":"Lau","year":"2011","journal-title":"Ann Diagn Pathol"},{"key":"2025042705550462000_2016.nov30_1.bcr2016216965.13","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s13304-011-0132-1","article-title":"Corticomedullary mixed tumor of the adrenal gland\u2014a clinical and pathological chameleon: case report and review of literature","volume":"65","author":"Donatini","year":"2013","journal-title":"Updates Surg"},{"key":"2025042705550462000_2016.nov30_1.bcr2016216965.14","doi-asserted-by":"crossref","first-page":"e37","DOI":"10.4158\/EP11222.CR","article-title":"Mixed corticomedullary carcinoma of the adrenal gland: a case report","volume":"18","author":"Turk","year":"2012","journal-title":"Endocr Pract"},{"key":"2025042705550462000_2016.nov30_1.bcr2016216965.15","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1007\/s00595-012-0458-4","article-title":"Mixed corticomedullary adrenal carcinoma","volume":"43","author":"Michalopoulos","year":"2013","journal-title":"Surg Today"},{"key":"2025042705550462000_2016.nov30_1.bcr2016216965.16","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1159\/000094323","article-title":"Ectopic ACTH syndrome","volume":"35","author":"Isidori","year":"2006","journal-title":"Front Horm Res"},{"key":"2025042705550462000_2016.nov30_1.bcr2016216965.17","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-012-9646-7"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2016-216965","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T12:55:16Z","timestamp":1745758516000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2016-216965"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11,30]]},"references-count":17,"alternative-id":["10.1136\/bcr-2016-216965"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2016-216965","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11,30]]}}}