PMC10235702_01
Clinical manifestations of CS with OAPS and severe PE during pregnancy. (A-C) The patient has clinical manifestations such as full moon face, centripetal obesity, purple striae on the abdomen, severe edema of the lower extremities; (D-E) Surgical posture of patients undergoing laparoscopic adrenalectomy; (F) The edema of the lower extremities was significantly relieved after surgical treatment.
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Physical examination showed: a body mass index of 29.3 kg/m2, full moon face, buffalo hump, acne visible on the chest and back, bulging abdomen, purple striae visible on the abdomen and inner thighs, and severe edema in both lower extremities ( Figure 1 ).
The imaging findings of the patient. (A-D) Plain MRI scan of the patient's abdomen showed an abnormal signal mass in front of the left kidney, which was about 4.7x3.3x3.7cm in size and had a clear boundary.
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T1W and slightly longer T2W abnormal signal mass in front of the left kidney, the size of which was about 47mm x 37mm ( Figure 2 ). The patient was initially diagnosed with pregnancy combined with an adrenal tumor resulting in ACTH-independent CS, accompanied by NC-OAPS and severe pre-eclampsia.
Pathological features of ACTH-independent CS during pregnancy caused by an adrenal adenoma. (A-C) The gross specimen of the tumor was a reddish-brown round mass, and the section of the tumor was golden after incision; (D-F) The tumor cells proliferated diffusely, and the cells of zona globularis, zona fasciculata, and zona reticularis could be seen.
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The capsule of the tumor was intact, and the surface was reddish brown ( Figure 3 ).