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 2
Biochemical investigations of Patient B in 2011 and 2016.
Test
Date
Reference Range
11/2011
12/2016
Serum
Renin
0.75
—
0.15–2.33 ng/mL/hr
Aldosterone
81
—
28–444 pmol/L
Estradiol
—
<133
<147 pmol/L
Testosterone
—
0.6
0.28–1.2 nmol/L
DHEA-S
—
33.0
0.5–5.6 umol/L
1 mg overnight dexamethasone suppression test (Cortisol)
612
666
<50 nmol/L
ACTH
13
<5
10–46 pg/ml
Urine
24 h
722
689
24–140 nmol/ day
24-hr urine adrenaline
32
—
<110 nmol/day
24-hr urine noradrenaline
298
—
<440 nmol/day
24-hr urine metanephrine
36
—
<275 nmol/day
24-hr urine normetanephrine
106
—
<240 nmol/day
Urinary steroid profiling
Free cortisol and cortisol intermediates and metabolites were grossly elevated
Moderate to large increases in free cortisol and cortisol metabolites. 17-OHP metabolites were grossly elevated
