Síndrome de Cushing debido a hiperplasia suprarenal macronodular independiente de ACTH tratado mediante adrenalectomía unilateral: dos casos

The causes and treatment of ACTH-independent macronodular adrenal hyperplasia as a cause of Cushing's syndrome remain unclear. A pituitary adenoma could be responsible for the adrenal hyperplasia, but the adrenal gland could be the primary problem in many cases. Less aggressive treatments such as unilateral laparoscopic adrenalectomy are increasingly used. We present two cases of ACTH-independent macronodular adrenal hyperplasia. These cases led us to reopen the debate about the etiology of the disease, given the presence of pituitary nodules in both patients and initially elevated ACTH values in the second patient. In both patients, unilateral adrenalectomy of the dominant gland (evaluated through computed tomography and scintigraphy) was performed with satisfactory outcomes in the medium term.