COMBINED CONNS AND CUSHINGS-SYNDROME - AN UNUSUAL PRESENTATION OF ADRENAL ADENOMA

In most aldosterone-producing adenomas (APA) dedifferentiation occurs with formation of transitional cells, bearing characteristics of both glomerulosa and fasciculata cells: These cells are able to produce cor tisol, and their aldosterone production follows the circadian rhythm o f ACTH. Usually, no clinical signs of cortisol excess develop, since t he cortisol production remains under ACTH feedback control. Only a few cases have been described with autonomous cortisol secretion, not sup pressible by low dose dexamethasone. We present a patient with an APA, synthesizing enough cortisol to cause the typical clinical expression of Gushing's syndrome. Possible etiopathological mechanisms are discu ssed.