{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:04:27Z","timestamp":1756339467096,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,1,16]]},"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>Recurrence of Cushing\u2019s syndrome due to functional metastasis from adrenocortical carcinoma (ACC) after adrenalectomy is extremely rare. We describe a case of a 56-year-old woman who presented with Cushing\u2019s syndrome due to an ACC. Abdominal CT showed a heterogeneous left adrenal tumour of 8\u2009cm as well as a right adrenal nodule with 3\u2009cm. An 18F-fluorodeoxyglucose positron emission tomography-CT (18F-FDG\/CT PET) revealed an increased uptake of both adrenal lesions (maximum standardised uptake values, 17.7 and 10.4 for left and right adrenal lesions, respectively). Patient underwent bilateral adrenalectomy with R0 resection. Pathological examination revealed a left ACC with a Weiss\u2019 score of 7, Ki67 10%, stage II European Network for the Study of Adrenal Tumours and a right adrenal adenoma. After surgery, clinical improvement was noted. Two months later, she noticed recurrence of hypercortisolism and multiple liver and lung metastasis were demonstrable, without evidence of local recurrence on the 18F-FDG\/CT PET and abdominal MRI.<\/jats:p>","DOI":"10.1136\/bcr-2021-246742","type":"journal-article","created":{"date-parts":[[2022,1,25]],"date-time":"2022-01-25T12:01:34Z","timestamp":1643112094000},"page":"e246742","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Functioning metastasis from adrenocortical carcinoma"],"prefix":"10.1136","volume":"15","author":[{"given":"Clara","family":"Cunha","sequence":"first","affiliation":[{"name":"Endocrinology, Centro Hospitalar de Lisboa Ocidental EPE Hospital de Egas Moniz, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Donato","sequence":"additional","affiliation":[{"name":"Endocrinology, Instituto Portugues de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1958-4531","authenticated-orcid":false,"given":"Tiago","family":"Silva","sequence":"additional","affiliation":[{"name":"Endocrinology, Instituto Portugues de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeriano","family":"Leite","sequence":"additional","affiliation":[{"name":"Endocrinology, Instituto Portugues de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal"},{"name":"Nova Medical School\/Faculdade de Ci\u00eancias M\u00e9dicas, Universidade Nova de Lisboa, Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,1,25]]},"reference":[{"key":"2025082707205110000_15.1.e246742.1","doi-asserted-by":"crossref","first-page":"G1","DOI":"10.1530\/EJE-18-0608","article-title":"European Society of endocrinology clinical practice 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