The female patient, reported on the December 7 issue 45 of World J Gastroenterology, presented a rare case, with symptoms consistent with hyperadrenocorticism and hypercatecholaminism, and also had a Cushingoid appearance.
The serum cortisol, dopamine and noradrenalin levels were elevated. Computed tomography detected a left adrenal mass measuring 3.5 cm -- 3.0 cm in diameter. Metaiodobenzylguanidine scintigraphy was negative. Unexpectedly, the serum carcinoembryonic antigen (CEA) level was elevated. Fluorodeoxyglucose positron emission tomography showed increased uptake in the adrenal tumor only, with a maximum standardized uptake value of 2.8. Selective venography and blood sampling revealed the concentrations of cortisol, catecholamines and carcinoembryonic antigen were significantly elevated in the drainage vein of the tumor. A diagnosis of carcinoembryonic antigen-producing benign adenoma was made. After preoperative management, Dr. Hori's group performed a combined lateral and anterior transperitoneal laparoscopic adrenectomy. The patient's vital signs remained stable during surgery. Histopathological examination revealed a benign adenoma. The cortisol, catecholamine and carcinoembryonic antigen levels normalized immediately after surgery.