Adrenal Tuberculosis: A Case Report and Literature Review

Huang H. · Gao L. · Li Y. · Tan W. · Wu H. · Yuan Y. · Liu C.

Author affiliations

Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

Log in to MyKarger to check if you already have access to this content.

Buy FullText & PDF Unlimited re-access via MyKarger Unrestricted printing, no saving restrictions for personal use
read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Rent via DeepDyve Unlimited fulltext viewing of this article Organize, annotate and mark up articles Printing and downloading restrictions apply

Start free trial

Subscribe Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use read more

Subcription rates

Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

Received: November 18, 2022
Accepted: February 06, 2023
Published online: April 19, 2023

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 2

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN

Abstract

Adrenal tuberculosis (TB) is a rare disease, which is difficult to diagnose because of its atypical symptoms. We reported a 41-year-old female who was admitted to hospital due to a left adrenal tumor, which was found in health examination without any symptoms. Abdominal CT showed a mass in her left adrenal. The results of blood test were normal. A retroperitoneal laparoscopic adrenalectomy was carried out, and adrenal TB was finally pathologically diagnosed. Following this, examinations focusing on TB were conducted which revealed negative results except for T-cell enzyme-linked immunospot. After the operation, the hormone level was normal. However, a wound infection occurred, which was recovered after antituberculosis treatment. In conclusion, even if there is no evidence of TB, we should be alert when diagnosing adrenal masses. Examinations of pathology, radiography, and hormone play important roles in determining the definite diagnosis of adrenal TB.

© 2023 S. Karger AG, Basel

References WHO. Global tuberculosis report 2022. Geneva: World Health Organization; 2022. Sener A, Erdem H, editors. Extrapulmonary tuberculosis. Switzerland: Springer Nature; 2019. Lam KY, Lo CY. A critical examination of adrenal tuberculosis and a 28-year autopsy experience of active tuberculosis. Clin Endocrinol. 2001;54(5):633–9. Storla DG, Yimer S, Bjune GA. A systematic review of delay in the diagnosis and treatment of tuberculosis. BMC Public Health. 2008;8:15. Norbis L, Alagna R, Tortoli E, Codecasa LR, Migliori GB, Cirillo DM. Challenges and perspectives in the diagnosis of extrapulmonary tuberculosis. Expert Rev Anti Infect Ther. 2014;12(5):633–47. van Haren Noman S, Visser H, Muller AF, Limonard GJ. Addison’s disease caused by tuberculosis: diagnostic and therapeutic difficulties. Eur J Case Rep Intern Med. 2018 Aug 28;5(8):000911. Imisairi AH, Hisham AN. Adrenal tuberculosis: the atypical presentations of eggshell-like calcifications. ANZ J Surg. 2009 Jun;79(6):488–9. Sharma S, Joshi R, Kalelkar R, Agrawal P. Tuberculous adrenal abscess presenting as adrenal insufficiency in a 4-year-old boy. J Trop Pediatr. 2019 Jun 1;65(3):301–4. Jiang H, Li A, Liao S, Ke S, Ji Z, Tian M, et al. Simultaneous adrenal tuberculosis and renal oncocytoma mimicking malignant masses incidentally detected by 18F-FDG PET/CT in a patient with lymphoma. Eur J Nucl Med Mol Imaging. 2022 Jan;49(2):777–8. Teng Q, Fan B, Wang Y, Wen S, Wang H, Liu T, et al. Primary adrenal tuberculosis infection in patients with Behcet’s disease presenting as isolated adrenal metastasis by 18F-FDG PET/CT: a rare case report and literature review. Gland Surg. 2021 Dec;10(12):3431–42. Yang N, Zhou L, Mo X, Huang G, Wu P. Successful treatment of severe electrolyte imbalance-induced cardiac arrest caused by adrenal tuberculosis with ECMO in the ED. Int J Emerg Med. 2021 Sep 20;14(1):55. Roudaut N, Malecot JM, Dupont E, Boussion N, Visvikis D, Doucet L, et al. Adrenal tuberculosis revealed by FDG PET. Clin Nucl Med. 2008 Nov;33(11):821–3. Shrestha B, Omran A, Rong P, Wang W. Successfully treated unusual case of primary adrenal and spinal tuberculosis with three years follow up. Pan Afr Med J. 2014 Feb 13;17:108. Liu H, Tang TJ, An ZM, Yu YR. Unilateral adrenal tuberculosis whose computed tomography imaging characteristics mimic a malignant tumor: a case report. World J Clin Cases. 2022 Jun 16;10(17):5783–8. Kwon HS, Kim SI, Yoo SJ, Yoon KH, Lee KW, Kang MW, et al. Adrenal tuberculosis in Cushing’s disease with bilateral macronodular adrenocortical hyperplasia. Endocr J. 2006 Apr;53(2):219–23. Xydakis AM, Chatzellis E, Kolomodi D, Kaltsas GA, Alexandraki KI. Adrenal failure and orchitis secondary to tuberculosis mimicking metastatic malignancy. Am J Med. 2020 Sep;133(9):e518–20. Patnaik MM, Deshpande AK. Diagnosis-Addison’s disease secondary to tuberculosis of the adrenal glands. Clin Med Res. 2008 May;6(1):29. Kim YY, Park SY, Oh YT, Jung DC. Adrenal tuberculosis mimicking a malignancy by direct hepatic invasion: emphasis on adrenohepatic fusion as the potential route. Clin Imaging. 2015 Sep-Oct;39(5):911–3. Jang SA, Park JH, Lee KA. Primary adrenal and chest wall tuberculosis presenting as an adrenal crisis. QJM. 2017 Jun 1;110(6):389–90. Arambewela M, Ross R, Pirzada O, Balasubramanian SP. Tuberculosis as a differential for bilateral adrenal masses in the UK. BMJ Case Rep. 2019 May 28;12(5):e228532. Soedarso MA, Nugroho KH, Meira Dewi KA. A case report: addison disease caused by adrenal tuberculosis. Urol Case Rep. 2018 May 26;20:12–4. Yu J, Lu Y, Han B. Primary adrenal insufficiency due to adrenal tuberculosis: a case report. J Int Med Res. 2020 Dec;48(12):300060520980590. Wan S, Du F, Wang J, Bao J, Mi J, Sun X. Primary unilateral and epilepsy adrenal tuberculosis misdiagnosed as adrenal tumor: report of two cases. Asian J Surg. 2021 Nov;44(11):1461–3. Upadhyay J, Sudhindra P, Abraham G, Trivedi N. Tuberculosis of the adrenal gland: a case report and review of the literature of infections of the adrenal gland. Int J Endocrinol. 2014;2014:876037. Walter JB, Israel MS, Tuberculosis in general pathology, Vol. 11. Edinburgh: Churchill livingstone; 1974. p. 244–52. Charmandari E, Nicolaides NC, Chrousos GP. Adrenal insufficiency. Lancet. 2014;383(9935):2152–67. MacLean E, Kohli M, Weber SF, Suresh A, Schumacher SG, Denkinger CM, et al. Advances in molecular diagnosis of tuberculosis. J Clin Microbiol. 2020;58(10):e01582–19. Wu T, Zhu P, Duan X, Yang X, Lu D. Calcifying fibrous pseudotumor of the adrenal gland: a rare case report. Mol Clin Oncol. 2016;5(3):252–4. Johnson PT, Horton KM, Fishman EK. Adrenal imaging with MDCT: nonneoplastic disease. AJR Am J Roentgenol. 2009;193(4):1128–35. Yang ZG, Guo YK, Li Y, Min PQ, Yu JQ, Ma ES. Differentiation between tuberculosis and primary tumors in the adrenal gland: evaluation with contrast-enhanced CT. Eur Radiol. 2006;16(9):2031–6. Guo YK, Yang ZG, Li Y, Ma ES, Deng YP, Min PQ, et al. Addison’s disease due to adrenal tuberculosis: contrast-enhanced CT features and clinical duration correlation. Eur J Radiol. 2007;62(1):126–31. Liatsikos EN, Kalogeropoulou CP, Papathanassiou Z, Tsota I, Athanasopoulos A, Perimenis P, et al. Primary adrenal tuberculosis: role of computed tomography and CT-guided biopsy in diagnosis. Urol Int. 2006;76(3):285–7. Fan ZM, Zeng QY, Huo JW, Bai L, Liu ZS, Luo LF, et al. Macronodular multi-organs tuberculoma: CT and MR appearances. J Gastroenterol. 1998;33(2):285–8. Collee JG, Miles RS, Watt B. Mackie MacCartney practical medical microbiology. New York: Churchill Livingstone; 1996. p. 329–41. Laway BA, Khan I, Shah BA, Choh NA, Bhat MA, Shah ZA. Pattern of adrenal morphology and function in pulmonary tuberculosis: response to treatment with antitubercular therapy. Clin Endocrinol. 2013;79(3):321–5. Kelestimur F. The endocrinology of adrenal tuberculosis: the effects of tuberculosis on the hypothalamo-pituitary-adrenal axis and adrenocortical function. J Endocrinol Invest. 2004;27(4):380–6. Huecker MR, Bhutta BS, Dominique E. Adrenal insufficiency. Treasure island (FL): StatPearls; 2022. Wan S, Sun X, Chang W, Mi J. Laparoscopic surgery in the treatment of rare adrenal tumors. Asian J Surg. 2021;44(5):759–60. Article / Publication Details

Received: November 18, 2022
Accepted: February 06, 2023
Published online: April 19, 2023

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 2

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN

Copyright / Drug Dosage / Disclaimer Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

留言 (0)

沒有登入
gif