Was It an Adrenocortical Adenoma or an Adrenocortical Carcinoma? Limitation of the Weiss Scoring System in Determining the Malignant Potential of Adrenocortical Tumor: Report on Two Cases
Table 1
Biochemical investigations of Patient A in 2012 and 2016.
Test
Date
Reference Range
8/2012
5/2016
Serum
Renin
0.45
2.91
0.15–2.33 ng/mL/hr
Aldosterone
267
<80
28–444 pmol/L
Estradiol
83
222
<147 pmol/L
Testosterone
3.8
4.2
0.28–1.2 nmol/L
DHEA-S
29.1
33.0
0.5–5.6 umol/L
1 mg overnight dexamethasone suppression test (Cortisol)
518
666
<50 nmol/L
ACTH
11
<5
10- 46 pg/ml
Urine
24-h urinary free cortisol
188
2798
24–140 nmol/ day
24-hr urine adrenaline
26
—
<110 nmol/day
24-hr urine noradrenaline
181
—
<440 nmol/day
24-hr urine metanephrine
105
—
<275 nmol/day
24-hr urine normetanephrine
120
—
<240 nmol/day
Urinary steroid profiling
Markedly increased free cortisol, cortisol metabolites, and androgen. Also, elevated levels of THS, 3-α, 16-α, 20-α-pregnenetriol, 3-β,16-α, 20-α-pregnenetriol, and 17-β androstenediol
