Diagnosis

♦ Clinical signs—Cushing's syndrome

—virilization —feminization

♦ Family history

♦ Haemoglobin, electrolytes, urea, liver function tests

♦ Urinary VMA, catecholamines

Table 21.1 Endocrine syndromes associated with adrenocortical tumours

Syndrome

Steroid

Cushing's syndrome (ACTH-independent)

Cortisol

Conn's syndrome/primary hyperaldosteronism

Aldosterone

Virilization syndrome

Androgen secretion

Feminization syndrome

Oestrogen secretion

Precocious puberty syndrome/adrenogenital

Sex hormones

syndrome

Non-functioning

None

♦ Plasma catecholamines

♦ Chromogranin assays

♦ Blood, urinary Cortisols

♦ Blood oestrogen, testosterone

♦ Chest X-ray, ultrasound, CT, MRI abdomen

♦ Ultrasound thyroid (MEN)

♦ 123I-MIBG, octreoscan—adrenal tumour

♦ Selenocholesterol imaging—cortical tumour

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