[Gammagraphic diagnosis of a non-hyperactive suprarenal adenoma]

It is described the case of a patient with Ovarian Cystadenoma in whom a 3.5 cm nodular lesion was accidentally detected in her left suprarenal gland. She had no signs of hypercortisolism or any other suprarenal pathology and was symptomless. Determinations in the urine of 24 hours of Cortisol, Adrenaline and Noradrenaline, 17-ketosteroids and Tetrahydroaldosterone were normal. Daily rhythm and plasmatic determinations of ACTH, cortisol and 11-deoxycortisol were normal. The Dexamethasone suppression test was also normal. In the suprarenal gammagraphy it appeared an intense captation by left suprarenal without visualization of right gland. A left suprarenalectomy was performed and the anatomopathological analysis showed a clear cell corticoadrenal adenoma. Therefore the only data of the function of suprarenal adenoma was the one coming from gammagraphy. We thought that the adenoma was responsible of practically all the corticoadrenal function without reaching pathological levels, meeting the criteria of "pre-Cushing" syndrome or subclinical Cushing, due to the fact that the contralateral gland was not seen in the gammagraphy. Therefore in the characterization of certain tumors which appear clinically and biochemically as non functional, the suprarenal gammagraphy could be a technique of great usefulness for the diagnosis.