{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:09Z","timestamp":1784557029687,"version":"3.55.0"},"reference-count":42,"publisher":"Bioscientifica","content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,9,1]]},"abstract":"Summary<\/jats:title>\n Objective: To recognize that benign adrenal adenomas can co-secrete excess aldosterone and cortisol, which can change clinical management.<\/jats:p>\n Methods: We reviewed the clinical and histological features of an adrenal tumor co-secreting aldosterone and cortisol in a patient. Biochemical testing as well as postoperative immunohistochemistry was carried out on tissue samples for assessing enzymes involved in steroidogenesis.<\/jats:p>\n Results: A patient presented with hypertension, hypokalemia, and symptoms related to hypercortisolism. The case demonstrated suppressed renin concentrations with an elevated aldosterone:renin ratio, abnormal dexamethasone suppression test results, and elevated midnight salivary cortisol concentrations. The patient had a right adrenal nodule with autonomous cortisol production and interval growth. Right adrenalectomy was carried out. Postoperatively, the patient tolerated the surgery, but he was placed on a short course of steroid replacement given a subnormal postoperative serum cortisol concentration. Long-term follow-up of the patient showed that his blood pressure and glucose levels had improved. Histopathology slides showed positive staining for 3\u03b2-hydroxysteroid dehydrogenase, 11\u03b2-hydroxylase, and 21 hydroxylase.<\/jats:p>\n Conclusion: In addition to the clinical manifestations and laboratory values, the presence of these enzymes in this type of tumor provides support that the tumor in this patient was able to produce mineralocorticoids and glucocorticoids. The recognition of patients with a tumor that is co-secreting aldosterone and cortisol can affect decisions to treat with glucocorticoids perioperatively to avoid adrenal crisis.<\/jats:p>\n \n Learning points<\/jats:title>\n \n \n \n Recognition of the presence of adrenal adenomas co-secreting mineralocorticoids and glucocorticoids.<\/jats:p>\n <\/jats:list-item>\n \n Consideration for perioperative and postoperative glucocorticoid use in the treatment of co-secreting adrenal adenomas.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1530\/edm-13-0042","type":"journal-article","created":{"date-parts":[[2013,9,30]],"date-time":"2013-09-30T08:59:26Z","timestamp":1380531566000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":3,"title":["Benign adrenal adenomas secreting excess mineralocorticoids and glucocorticoids"],"prefix":"10.1530","volume":"2013","author":[{"given":"Vivienne","family":"Yoon","sequence":"first","affiliation":[{"name":"Department of Internal Medicine\/Division of Endocrinology and Metabolism, VA North Texas Health Care System and the University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-8857, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliya","family":"Heyliger","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\/Division of Endocrinology and Metabolism, VA North Texas Health Care System and the University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-8857, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Maekawa","sequence":"additional","affiliation":[{"name":"1 Department of Pathology, Tohoku University School of Medicine and Hospital at Sendai, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hironobu","family":"Sasano","sequence":"additional","affiliation":[{"name":"1 Department of Pathology, Tohoku University School of Medicine and Hospital at Sendai, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelley","family":"Carrick","sequence":"additional","affiliation":[{"name":"2 Departments of Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey","family":"Woodruff","sequence":"additional","affiliation":[{"name":"3 Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Rabaglia","sequence":"additional","affiliation":[{"name":"3 Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J","family":"Auchus","sequence":"additional","affiliation":[{"name":"4 Department of Internal Medicine\/Division of Metabolism, Endocrinology and Diabetes, University of Michigan Health System, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans K","family":"Ghayee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\/Division of Endocrinology and Metabolism, VA North Texas Health Care System and the University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-8857, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"ref31","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1210\/jc.2008-0125","article-title":"The Diagnosis of Cushing's Syndrome: An Endocrine Society Clinical Practice Guidelines","volume":"93","year":"2008","journal-title":"Journal of Clinical Endocrinology and 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Endocrinology"},{"key":"ref381","doi-asserted-by":"crossref","first-page":"628","DOI":"10.2169\/internalmedicine.36.628","article-title":"Preclinical Cushing's syndrome due to adrenocorticotropin-independent bilateral adrenocortical macronodular hyperplasia with concurrent excess of gluco- and mineralocorticoids","volume":"36","year":"1997","journal-title":"Internal Medicine"},{"key":"ref11","first-page":"534","article-title":"Adrenal Textbook of ch pp Philadelphia","volume":"12","author":"Melmed","year":"2011","journal-title":"Cortex Endocrinology edn"},{"key":"ref241","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1210\/jc.2008-0125","article-title":"The Diagnosis of Cushing's Syndrome: An Endocrine Society Clinical Practice Guidelines","volume":"93","year":"2008","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref351","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1007\/s10157-006-0413-z","article-title":"Coexistence of three 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Investigator"},{"key":"ref131","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1507\/endocrj.48.103","article-title":"A case of aldosterone-producing adrenocortical adenoma associated with preclinical Cushing's syndrome and hypersecretion of parathyroid hormone","volume":"48","year":"2001","journal-title":"Endocrine Journal"},{"key":"ref201","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1111\/j.1440-1681.1993.tb01686.x","article-title":"Cortisol production by aldosterone-producing adenomas in vitro","volume":"20","year":"1993","journal-title":"Clinical and Experimental Pharmacology & Physiology"},{"key":"ref301","doi-asserted-by":"crossref","first-page":"123","DOI":"10.2169\/internalmedicine.35.123","article-title":"Adrenal tumor producing 11-deoxycorticosterone, 18-hydroxy-11-deoxycorticosterone and aldosterone","volume":"35","year":"1996","journal-title":"Internal Medicine"},{"key":"ref71","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1111\/j.1365-2265.2009.03551.x","article-title":"High prevalence of autonomous cortisol and aldosterone secretion from adrenal adenomas","volume":"71","year":"2009","journal-title":"Clinical Endocrinology"}],"container-title":["Endocrinology, Diabetes & Metabolism Case Reports"],"original-title":[],"link":[{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2013\/1\/EDM13-0042.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2013\/1\/EDM13-0042.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:45:49Z","timestamp":1784555149000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/edm\/article\/81"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,9,1]]},"references-count":42,"URL":"https:\/\/doi.org\/10.1530\/edm-13-0042","relation":{},"ISSN":["2052-0573","2052-0573"],"issn-type":[{"value":"2052-0573","type":"print"},{"value":"2052-0573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,9,1]]}}}