{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:24:31Z","timestamp":1791559471258,"version":"4.3.4"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017501","name":"Science-Health Joint Medical Scientific Research Project of Chongqing","doi-asserted-by":"publisher","award":["2025ZDXM006"],"award-info":[{"award-number":["2025ZDXM006"]}],"id":[{"id":"10.13039\/100017501","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012397","name":"Army Medical University","doi-asserted-by":"publisher","award":["2023BJG209"],"award-info":[{"award-number":["2023BJG209"]}],"id":[{"id":"10.13039\/501100012397","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>Perioperative dexamethasone is commonly used in enhanced recovery protocols, yet its safety in adrenalectomy remains underevaluated. We report a 33-year-old woman who developed postoperative adrenal crisis\u2013like deterioration 54 hours after right adrenalectomy for a radiologically and biochemically non-functioning adrenal tumor on basal preoperative testing. A single 5 mg intravenous dose of dexamethasone was administered intraoperatively for antiemetic prophylaxis. During clinical deterioration, the patient exhibited marked suppression of ACTH and cortisol, consistent with pharmacological glucocorticoid effects in the perioperative period. However, the clinical presentation was non-specific and alternative postoperative complications, including infection, thromboembolic disease, and metabolic disturbances, could not be fully excluded. The patient improved following combined supportive therapy and stress-dose hydrocortisone. Preoperative endocrine evaluation did not include a 1 mg overnight dexamethasone suppression test, and mild autonomous cortisol secretion could not be excluded. Dynamic assessment of adrenal reserve was not performed preoperatively. This case highlights that perioperative dexamethasone may be temporally associated with postoperative endocrine perturbations that mimic adrenal crisis in susceptible patients. However, causality cannot be established, and careful differential diagnosis is essential in the postoperative setting following adrenal surgery.<\/jats:p>","DOI":"10.3389\/fendo.2026.1829308","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T04:20:19Z","timestamp":1784607619000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case report: Suspected adrenal crisis after non-functional adrenal tumor resection: a case of temporal association with perioperative dexamethasone"],"prefix":"10.3389","volume":"17","author":[{"given":"Shuai","family":"He","sequence":"first","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital (Southwest Hospital) of Army Medical University","place":["Chongqing, China"]},{"name":"Institute of Urology, The First Affiliated Hospital (Southwest Hospital) of Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lifang","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, The First Affiliated Hospital (Southwest Hospital) of Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Yang","sequence":"additional","affiliation":[{"name":"International Centre for Aging and Cancer, Hainan Medical University","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunxia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital (Southwest Hospital) of Army Medical University","place":["Chongqing, China"]},{"name":"Institute of Urology, The First Affiliated Hospital (Southwest Hospital) of Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuchen","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, The First Affiliated Hospital (Southwest Hospital) of Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital (Southwest Hospital) of Army Medical University","place":["Chongqing, China"]},{"name":"Institute of Urology, The First Affiliated Hospital (Southwest Hospital) of Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital (Southwest Hospital) of Army Medical University","place":["Chongqing, China"]},{"name":"Institute of Urology, The First Affiliated Hospital (Southwest Hospital) of Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital (Southwest Hospital) of Army Medical University","place":["Chongqing, China"]},{"name":"Institute of Urology, The First Affiliated Hospital (Southwest Hospital) of Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongquan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital (Southwest Hospital) of Army Medical University","place":["Chongqing, China"]},{"name":"Institute of Urology, The First Affiliated Hospital (Southwest Hospital) of Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-0085","article-title":"Medical and surgical evaluation and treatment of adrenal incidentalomas","volume":"96","author":"Zeiger","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.07.2799","article-title":"The incidental adrenal mass on CT: prevalence of adrenal disease in 1,049 consecutive adrenal masses in patients with no known Malignancy","volume":"190","author":"Song","year":"2008","journal-title":"AJR Am J Roentgenol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgz284","article-title":"Adrenal incidentalomas are tied to increased risk of diabetes: Findings from a prospective study","volume":"105","author":"Reimondo","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1530\/edm-23-0120","article-title":"A case of adrenal cortical carcinoma arising from a regularly monitored sub-centimetre adrenal incidentaloma","volume":"2024","author":"Parry","year":"2024","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"key":"B5","doi-asserted-by":"publisher","first-page":"894","DOI":"10.1016\/s2213-8587(20)30314-4","article-title":"Epidemiology of adrenal tumours in Olmsted County, Minnesota, USA: a population-based cohort study","volume":"8","author":"Ebbehoj","year":"2020","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1590\/s0100-879x2000001000007","article-title":"A survey on adrenal incidentaloma in Italy. Study Group on Adrenal Tumors of the Italian Society of Endocrinology","volume":"85","author":"Mantero","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.7326\/m22-1619","article-title":"Prevalence and characteristics of adrenal tumors in an unselected screening population : A cross-sectional study","volume":"175","author":"Jing","year":"2022","journal-title":"Ann Intern Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"G1","DOI":"10.1093\/ejendo\/lvad066","article-title":"European Society of Endocrinology clinical practice guidelines on the management of adrenal incidentalomas, in collaboration with the European Network for the Study of Adrenal Tumors","volume":"189","author":"Fassnacht","year":"2023","journal-title":"Eur J Endocrinol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1097\/aln.0b013e31827773e9","article-title":"Practice guidelines for postanesthetic care: an updated report by the American Society of Anesthesiologists Task Force on Postanesthetic Care","volume":"118","author":"Apfelbaum","year":"2013","journal-title":"Anesthesiology"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2028982","article-title":"Dexamethasone and surgical-site infection","volume":"384","author":"Corcoran","year":"2021","journal-title":"N Engl J Med"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-1710","article-title":"Diagnosis and treatment of primary adrenal insufficiency: An Endocrine Society clinical practice guideline","volume":"101","author":"Bornstein","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"B12","article-title":"Adrenal crisis precipitated by dexamethasone therapy in a hypertensive addisonian","volume":"57","author":"Jaecks","year":"1966","journal-title":"J Maine Med Assoc"},{"key":"B13","article-title":"Acute adrenal insufficiency in patients with leukemia treated with dexamethasone","volume":"33","author":"Vasil'eva","year":"1970","journal-title":"Sov Med"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.31138","article-title":"Dexamethasone swish and spit: A cause of iatrogenic adrenal insufficiency","volume":"71","author":"Kesari","year":"2024","journal-title":"Pediatr Blood Cancer"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1829308\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T04:20:21Z","timestamp":1784607621000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1829308\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":14,"alternative-id":["10.3389\/fendo.2026.1829308"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1829308","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,21]]},"article-number":"1829308"}}