{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:33Z","timestamp":1784557053020,"version":"3.55.0"},"reference-count":14,"publisher":"Bioscientifica","content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,5,1]]},"abstract":"Summary<\/jats:title>\n \n A functional lesion in corticotrophin (ACTH)-independent Cushing\u2019s syndrome is difficult to distinguish from lesions of bilateral adrenal masses. Methods for distinguishing these lesions include adrenal venous sampling and\n 131<\/jats:sup>\n I-6\u03b2-iodomethyl-19-norcholesterol (\n 131<\/jats:sup>\n I-NP-59) scintigraphy. We present a case of a 29-year-old Han Chinese female patient with a history of hypercholesterolaemia and polycystic ovary syndrome. She presented with a 6month history of an 8kg body weight gain and gradual rounding of the face. Serial examinations revealed loss of circadian rhythm of cortisol, elevated urinary free-cortisol level and undetectable ACTH level (<5pg\/mL). No suppression was observed in both the low- and high-dose dexamethasone suppression tests. Adrenal computed tomography revealed bilateral adrenal masses. Adrenal venous sampling was performed, and the right-to-left lateralisation ratio was 14.29. The finding from adrenal scintigraphy with NP-59 was consistent with right adrenal adenoma. The patient underwent laparoscopic right adrenalectomy, and the pathology report showed adrenocortical adenoma. Her postoperative cortisol level was 3.2\u03bcg\/dL, and her Cushingoid appearance improved. In sum, both adrenal venous sampling and\n 131<\/jats:sup>\n I-NP-59 scintigraphy are good diagnostic methods for Cushing\u2019s syndrome presenting with bilateral adrenal masses.\n <\/jats:p>\n \n Learning points<\/jats:title>\n \n \n \n The clinical presentation of Cushing\u2019 syndrome includes symptoms and signs of fat redistribution and protein-wasting features.<\/jats:p>\n <\/jats:list-item>\n \n The diagnosis of patients with ACTH-independent Cushing\u2019s syndrome with bilateral adrenal masses is challenging for localisation of the lesion.<\/jats:p>\n <\/jats:list-item>\n \n \n Both adrenal venous sampling and\n 131<\/jats:sup>\n I-NP-59 scintigraphy are good methods to use in these patients with Cushing\u2019s syndrome presenting with bilateral adrenal masses.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1530\/edm-15-0118","type":"journal-article","created":{"date-parts":[[2016,5,13]],"date-time":"2016-05-13T09:36:08Z","timestamp":1463132168000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":1,"title":["A case of adrenal Cushing\u2019s syndrome with bilateral adrenal masses"],"prefix":"10.1530","volume":"2016","author":[{"given":"Ya-Wun","family":"Guo","sequence":"first","affiliation":[{"name":"1 Department of Medicine, Taipei City Hospital, Zhongxing Branch, Taipei, Taiwan"},{"name":"2 Department of Medicine, Division of Endocrinology and Metabolism, Taipei Veterans General Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chii-Min","family":"Hwu","sequence":"additional","affiliation":[{"name":"2 Department of Medicine, Division of Endocrinology and Metabolism, Taipei Veterans General Hospital, Taipei, Taiwan"},{"name":"3 Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin Ging-Shing","family":"Won","sequence":"additional","affiliation":[{"name":"2 Department of Medicine, Division of Endocrinology and Metabolism, Taipei Veterans General Hospital, Taipei, Taiwan"},{"name":"3 Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Huei","family":"Chu","sequence":"additional","affiliation":[{"name":"3 Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan"},{"name":"4 Department of Otorhinolaryngology-Head and Neck Surgery, Division of Otology, Taipei Veterans General Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang-Yu","family":"Lin","sequence":"additional","affiliation":[{"name":"2 Department of Medicine, Division of Endocrinology and Metabolism, Taipei Veterans 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