Rebound thymic hyperplasia after adrenalectomy in a patient with Cushing syndrome caused by adrenocortical adenoma: A case report. Issue 15 (April 2018)

• Record Type: Journal Article
• Authors: Hwang, Jung Won; Hwang, Pyoung Han
• Other Names: Hassan. Tamer section editor.
• Is Part Of: Medicine. Volume 97:Issue 15(2018)
• Publication Date: 2018-04
• Subjects: adrenalectomy -- Cushing syndrome -- rebound thymic hyperplasia; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000010367
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: The development of rebound thymic hyperplasia (RTH) has been reported in patients who have recovered from stressful conditions such as surgery and steroid therapy. We report a case of RTH following the resolution of hypercortisolism after adrenalectomy for the treatment of adrenocortical adenoma in a patient with Cushing syndrome. Patient concerns: A 5-month-old female infant with a history of overeating, hirsutism, and excessive weight gain for the previous 2 months was referred to the hospital. The laboratory results revealed elevated 24-hour urinary free cortisol levels. An overnight dexamethasone suppression test showed no response. Abdominal imaging revealed a right-sided suprarenal mass measuring 4_3cm. Histology showed an adrenocortical adenoma. Thus, she underwent a right adrenalectomy. Diagnoses: The patient showed clinical improvement with weight loss and normal cortisol levels over the next 4 months. Six months after the operation, a chest computed tomography showed enlargement of the left thymic lobe, which was previously nonexistent. Interventions: A fine needle aspiration biopsy was performed, and histological examination revealed diffuse thymic hyperplasia. Outcomes: At the 1-year follow-up, the chest imaging studies showed resolution of the RTH. Lessions: An understanding of RTH after adrenalectomy as a treatment for cortisol-producing adrenocortical tumors is important for the prevention of unnecessary surgical intervention and therapy.