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Bilateral Adrenal Adenoma Presented As Multiple Metatarsal And Phalangeal Fractures
1Department of Orthopaedics and Traumatology, North District Hospital 9 Po Kin Road, Sheung Shui, NT, Hong Kong SAR, China.
Introduction:
Symptomatic adrenal adenoma usually presents with systemic symptoms. Depending on the function of the adenoma, the patient can present with pheochromocytoma-like symptoms; primary hyperaldosteronism and Cushing syndrome (weight gain, weakness, depression, and bruising).
Case Report:
A 41 year-old lady presented with multiple metatarsal and phalangeal fractures of the both feet without significant injury. DEXA scan showed evidence of osteoporosis. Investigations showed that the picture was compatible with adrenal Cushing syndrome. Computed tomogram showed bilateral adrenal adenoma. Adrenal cortex scintigraphy with NP-59 scan showed hyperfunctioning right adrenal adenoma. Laproscopic R adrenalectomy was performed and histological study confirmed adrenal cortical adenoma with adjacent cortical atrophy suggestive of a functioning adenoma. Post-operatively, she was put on hydrocortisone replacement and recovered well.
Conclusion:
Adrenal adenoma can present with insufficiency fractures of the feet.
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