Abstract
BackgroundCushing syndrome coexisting with multiple myeloma has been previously described in a few reports. Overlapping clinical manifestations can lead to misdiagnoses.Case presentationWe presented an extremely rare case of a 33-year-old Thai woman with concomitant kappa light chain myeloma with adrenal Cushing syndrome, both of which were related to skeletal manifestations. A precedence report indicated that treatment of the Cushing syndrome could exacerbate the myeloma symptoms. Therefore, we were faced with the dilemma of which disease should be addressed first. We decided to treat our patient with a combination chemotherapy followed by an autologous stem cell transplant. Subsequently, a left laparoscopic adrenalectomy was successfully undertaken.ConclusionWe have reported the first association between adrenocorticotropic hormone-independent Cushing syndrome resulting from a left autonomous cortisol-secreting adrenal adenoma, and multiple myeloma.
Highlights
Cushing syndrome coexisting with multiple myeloma has been previously described in a few reports
We have reported the first association between adrenocorticotropic hormone-independent Cushing syndrome resulting from a left autonomous cortisol-secreting adrenal adenoma, and multiple myeloma
Cushing syndrome (CS) is a serious condition resulting from chronic exposure to cortisol excess, and it is associated with increased risks of cardiovascular, metabolic, and psychiatric complications, and osteoporosis
Summary
We have reported the first case of ACTH-independent CS from a left autonomous cortisol-secreting adrenal adenoma in a patient with myeloma. Abbreviations 17-OHSC: 17-hydroxycorticosteroids; ACTH: Adrenocorticotropic hormone; AVS: Adrenal venous sampling; BW: Body weight; CD: Cushing disease; CS: Cushing syndrome; ECS: Endogenous Cushing syndrome; Hb: Hemoglobin; IMWG: International Myeloma Working Group; MM: Multiple myeloma; UFC: Urinary free cortisol; VCD: Bortezomib, cyclophosphamide, and dexamethasone; WBC: White blood cell
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