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Mrs L Ghataore1
September 2008
10-day left sided abdominal pain
2-day history of dry cough
Examination:
Large firm mass in the left upper abdomen
Some reduced breath sounds in the left lung base
Radiology [CT - Abdomen (coronal)]
Right lung
lesion
Mass
15 x 19 x
18 cm
Radiology [CT - Chest (axial)]
Right lung
lesions
Radiology [CT - Abdomen (axial)]
Lymph node
involvement
paraaortic
&
Blood
periportal
vessels
Mass
15 x 19 x
18 cm
Biochemical investigations
Tests Results
Renal, Liver, Bone profiles Normal
24 hr urine CATS (x2) Normal
Aldosterone/Renin Normal
24 hr urine cortisol: 164 (30-250nmol/D)
Cortisol (DST=0.5, 48 hr): 178 (<30 nmol/L)
ACTH 34ng/L (<50 ng/L, 9am)
17OH progesterone 12.8 (<19.6nmol/L)
DHEAS 14.7 (7.6-17.4umol/L)
Progesterone: 10 (<5nmol/L)
Androstenedione: 24.1 (2.4-12.6nmol/L)
Urine Steroid Profiling (USP)
Cholesterol DP3
20,22-lyase
Oestrone Oestradiol
11-Deoxycorticosterone 11-Deoxycortisol 17-HSD
11-hydroxylase
11-hydroxylase
Corticosterone
THS X
Aldosterone synthase
Cortisol
Aldosterone
Normal vs abnormal USP
28.64
18.77
29.93
30.22
%
22.52 24.61
DP3 S CB
38.14
DHA21.47 25.67
30.50 34.72
24.22 THS
19.14 28.24
32.08
33.78
0
garrard neil 14-09 1: Scan EI+
100
Patient 25y TIC
A 3.99e9
DHA
19.84 DP3
% THS 28.36
18.84
26.38
20.22 30.05
18.39 25.77
23.55
30.32
22.14
32.17
S
34.83 CB
38.18
0 Time
18.00 23.00 28.00 33.00 38.00
USP: Pre & Post Dexamethasone
DHA DP3
19.84
% THS 28.36
18.84
26.38
20.22 30.05
A18.39 23.55
25.77
30.32
22.14 S CB
32.17 34.83 38.18
0
garrard neill 17-9 Scan EI+
Patient 17-9-8
18.84
Post Dex TIC
100
2.42e9
DP3
DHA THS 28.34
25.76
19.80
23.55
23.37 30.01
CB
21.47 30.58 S
34.79
38.17
32.12
39.82
0 Time
18.00 23.00 28.00 33.00 38.00
Surgery
DHA
19.84
DP3
% THS 28.36
18.84
26.38
20.22 30.05
18.39 25.77
A 23.55
30.32
22.14 S
34.83
CB
32.17 38.18
0
garrard neill 3-12 Scan EI+
Patient 03-12-8
100
18.77 Post TIC
A 1.46e9
28.55 29.79
24.55 25.61
DP3 30.39 S
DHA 34.64 CB
38.06
19.08 22.49
23.44
THS
28.16
31.07
26.26
0 Time
18.00 23.00 28.00 33.00 38.00
Pharmacotherapy
28.55 29.79
%
5α
24.55 25.61 30.39
S
34.64 CB
28.16 38.06
19.08 22.49
23.44 26.26
20β
31.07
0
garrard neill 9-1 Scan EI+
100 Patient 9-1-10 Post 29.79 TIC
2.58e9
A16.69
19.90
%
5α
28.53
An 20β
30.38
21.47
18.75
27.85
S
34.64
CB
38.09
25.58 31.87
0 Time
18.00 23.00 28.00 33.00 38.00
USP: Follow-up
100000
10000
Excretion (ug/24h)
1000
pregnenetriol
THS
100
DHA + DHA metabs
10
Mild gynaecomastia
Endo-NET MDM
P649735