ADRENAL CORTICAL CARCINOMA PRESENTING AS CENTRAL SEROUS CHORIORETINOPATHY

The authors describe a case of bilateral chronic central serous chorioretinopathy secondary to adrenal cortical carcinoma.

A case report of a 70-year-old Hispanic man presenting with bilateral multifocal central serous chorioretinopathy.

Clinical findings of bilateral chronic central serous chorioretinopathy along with 160 µ m of subretinal fluid and choroidal thickness greater than 400 µ m without enhanced depth optical coherence tomography were noted in a patient presenting with distortion in vision in both eyes and a weight gain of 15 pounds, weakness, and fatigue starting 8 months before. Further endocrine testing showed an elevated 24-hour urinary free cortisol level of 137 µ g with no change in serum cortisol levels following the low-dose dexamethasone suppression test and undetectable serum adrenocorticotropic hormone levels consistent with adrenocorticotropic hormone-independent Cushing syndrome. Imaging of the abdomen revealed heterogeneously enhancing masses, and the biopsy of the adrenal tumor led to the diagnosis of adrenal cortical carcinoma. He died 3 weeks after starting hospice care and only completed one round of chemotherapy.

Adrenal tumors, including adrenal cortical carcinoma, may present as bilateral chronic central serous chorioretinopathy.