case_images: PMC10775748_01
case_images: PMC10775748_02
case_images: Diagnostic images of the three patients. (a) Abdominal computed tomography (CT) showed poorly enhancing nodular lesions with unclear boundaries. (b) Abdominal CT revealed an increase in liver volume, with multiple masses showing annular enhancement. In addition, there was a mass in the tail of the pancreas that was uniformly enhancing and invaded the spleen. (c) Abdominal CT showed multiple round, low-density nodules in the liver, with mild annular enhancement. (d-f) CT showed adrenal hyperplasia (arrows) and (g-i) Pituitary enhanced magnetic resonance imaging showed that the size, shape, and signal strength of the pituitary gland were normal.
case_images: 10.1177_03000605231220867-fig2.jpg
case_images: PMC10775748_08_10.1177_03000605231220867-fig2.jpg
case_images: fig2-03000605231220867
case_images: Pituitary enhanced MRI did not indicate any abnormalities (Figure 2c, 2f, 2i).
case_images: PMC10775748_03
case_images: PMC10775748_04
case_images: Timing of the start of mitotane administration (arrows) and the subsequent changes in the serum cortisol concentrations of the three patients.
case_images: 10.1177_03000605231220867-fig1.jpg
case_images: PMC10775748_09_10.1177_03000605231220867-fig1.jpg
case_images: fig1-03000605231220867
case_images: After 14 days of treatment, her cortisol concentration had returned to normal (Figure 1); and her serum potassium, blood pressure, and blood sugar were under control; without any adverse events being recorded.
case_images: PMC10775748_05
case_images: Diagnostic images of the three patients. (a) Abdominal computed tomography (CT) showed poorly enhancing nodular lesions with unclear boundaries. (b) Abdominal CT revealed an increase in liver volume, with multiple masses showing annular enhancement. In addition, there was a mass in the tail of the pancreas that was uniformly enhancing and invaded the spleen. (c) Abdominal CT showed multiple round, low-density nodules in the liver, with mild annular enhancement. (d-f) CT showed adrenal hyperplasia (arrows) and (g-i) Pituitary enhanced magnetic resonance imaging showed that the size, shape, and signal strength of the pituitary gland were normal.
case_images: 10.1177_03000605231220867-fig2.jpg
case_images: PMC10775748_08_10.1177_03000605231220867-fig2.jpg
case_images: fig2-03000605231220867
case_images: Pituitary enhanced MRI did not indicate any abnormalities (Figure 2c, 2f, 2i).
case_images: PMC10775748_06
case_images: PMC10775748_07
case_images: PMC10775748_08
case_images: Diagnostic images of the three patients. (a) Abdominal computed tomography (CT) showed poorly enhancing nodular lesions with unclear boundaries. (b) Abdominal CT revealed an increase in liver volume, with multiple masses showing annular enhancement. In addition, there was a mass in the tail of the pancreas that was uniformly enhancing and invaded the spleen. (c) Abdominal CT showed multiple round, low-density nodules in the liver, with mild annular enhancement. (d-f) CT showed adrenal hyperplasia (arrows) and (g-i) Pituitary enhanced magnetic resonance imaging showed that the size, shape, and signal strength of the pituitary gland were normal.
case_images: 10.1177_03000605231220867-fig2.jpg
case_images: PMC10775748_08_10.1177_03000605231220867-fig2.jpg
case_images: fig2-03000605231220867
case_images: Pituitary enhanced MRI did not indicate any abnormalities (Figure 2c, 2f, 2i).
case_images: Histological images of the liver mass of case 3, stained with hematoxylin and eosin (HE) or immunohistochemical stains. (a) HE, original magnification x400. (b, c) Tumor cells, immunostaining positive for synaptophysin and somatostatin receptor 2, original magnification x400. (d) The Ki-67 index of tumor cells was approximately 22% and (e, f) Some tumor cells immunostained positive for adrenocorticotropic hormone, original magnification x400.
case_images: 10.1177_03000605231220867-fig3.jpg
case_images: PMC10775748_08_10.1177_03000605231220867-fig3.jpg
case_images: fig3-03000605231220867
case_images: Examination of the liver biopsy revealed a grade 3 (G3) neuroendocrine tumor with a Ki-67 index of 22% and positive immunostaining for ACTH (Figure 3), implying the presence of EAS.
case_images: PMC10775748_09
case_images: Timing of the start of mitotane administration (arrows) and the subsequent changes in the serum cortisol concentrations of the three patients.
case_images: 10.1177_03000605231220867-fig1.jpg
case_images: PMC10775748_09_10.1177_03000605231220867-fig1.jpg
case_images: fig1-03000605231220867
case_images: After 14 days of treatment, her cortisol concentration had returned to normal (Figure 1); and her serum potassium, blood pressure, and blood sugar were under control; without any adverse events being recorded.