PRIMARY SUPRARENAL GLANDULAR TUBERCULOSIS MIMICKING A MALIGNANT TUMOR

##plugins.themes.bootstrap3.article.main##

##plugins.themes.bootstrap3.article.sidebar##

PDF
Published 2023-09-01
Hikmat Satria Kurnia Penta Seputra Basuki Bambang Purnomo

Abstract

ABSTRAK Objective: Our case demonstrates effective tuberculosis-related Addison's disease care with laparoscopic adrenalectomy and anti-tuberculosis medication. Case(s) Presentation: A 43-year-old patient complained of left flank pain for two months before admission, unexplained weight loss, general weakness, decreased appetite, and without long-term cough. The physical examination resulted in hyperpigmentation on the fingers of both hands. MRI revealed an enlarged left adrenal gland and the blood test showed elevated cortisol to 1668 mmol/L. Three-port left laparoscopic transperitoneal adrenalectomy was used. Histopathology results showed epitheloid histiocytes that formed granulomas with caseous necrosis and Datia Langerhans cells referring to tuberculosis; no malignancy was found from the same sample. Discussion: Addison's illness is the primary cause of tuberculosis. Due to the widespread use of anti-TB medications, the incidence of adrenal tuberculosis has been on the decline recently; nonetheless, in developing nations, tuberculosis is still the predominant cause of Addison's disease. Conclusion: Surgery and standard treatment for extrapulmonary tuberculosis were adequate to diagnose and alleviate the symptoms of cortisol disturbance caused by Addison’s disease. Keywords: Endocrine glands, adrenalectomy, tuberculosis endocrine.


##plugins.themes.bootstrap3.article.details##

Keywords

Endocrine glands, Adrenalectomy, Tuberculosis endocrin

References

Sarin B, Sibia K, Kukreja S. Study of adrenal function in patients with tuberculosis. Indian J Tuberc. 2018; 65(3): 241–5.

Vinnard C, Blumberg E. Endocrine and metabolic aspects of tuberculosis. Tuberculosis and Nontuberculous Mycobacterial Infections. 2021; 5(1): 436–47.

Upadhyay J, Sudhindra P, Abraham G, Al E. Tuberculosis of the adrenal gland: a case report and review of the literature of infections of the adrenal gland. International Journal of Endocrinology. 2014.

Sarkar S, Sarkar S, Ghosh S, Al. E. Addison’s disease. Contemporary clinical dentistry. 2012; 3(4): 484.

Kim W, Lee J. Adrenal Tuberculosis Mimicking a Malignant Tumor with Primary Adrenal Insufficiency. Soonchunhyang Med Sci. 2017; 23(1): 49–51.

Maller V, Afzal M, Shankar S. Primary adrenal tuberculosis causing adrenal insufficiency. Hong Kong J Radiol. 2016; 19: e6–9.

Nomura K, Demura H, Saruta T. Addison’s disease in Japan: characteristics and changes revealed in a nationwide survey. Intern Med. 1994; 33(10): 602–6.

Barnett A, Espiner E, Donald R. Patients presenting with Addison’s disease need not be pigmented. Postgrad Med J. 1982; 58(685): 690–2.

Nagler M, Müller B, Briner V, Al E. Severe hyperkalemia and bilateral adrenal metastasis. J Oncol. 2009; 2009.

Lanza A, Heulfe I, Perillo L, Al E. Oral pigmentation as a sign of Addison’s disease: a brief reappraisal. Open Dermatol J. 2009; 3(1).

Namikawa H, Takemoto Y, Kainuma S, Al E. Addison’s Disease Caused by Tuberculosis with Atypical Hyperpigmentation and Active Pulmonary Tuberculosis. Intern Med. 2017; 56(14): 1843–7.

Dabrowska A, Tarach J, Prystupa A, Al E. Addison’s disease due to tuberculosis of the adrenal glands. J Pre-Clinical Clin Res. 2012; 6(2); 88-92.

Rajesh B, Mahendran M, Kumar P. Primary Adrenal Tuberculosis Presenting as Addison’s Disease. Journal Indian Academy of Clinical Medicine. 2018; 19(3): 233-234.

Soedarso M, Nugroho K, Dewi K. A case report: Addison disease caused by adrenal tuberculosis. Urol case reports. 2018; 20: 12–4.

Section
Articles
Copyright Information
Department of Urology, Faculty of Medicine/Airlangga University