case_images: PMC10882191_01
case_images: Imaging finding of bilateral adrenal tumors. (A): A contrast-enhanced CT image showing bilateral adrenal tumors (arrow). (B): A fluorodeoxyglucose positron emission tomography image showing abnormal uptake on bilateral adrenal tumors. (C): 123I-metaiodobenzylguanidine scintigraphy showing increased uptake in the right adrenal gland.
case_images: cureus-0016-00000052760-i01.jpg
case_images: PMC10882191_01_cureus-0016-00000052760-i01.jpg
case_images: FIG1
case_images: A contrast abdominal CT scan was performed, showing bilateral adrenal tumors (Figure 1A). Imaging studies showed increased uptake on fluorodeoxyglucose (FDG) positron emission tomography (PET), consistent with bilateral adrenal masses, (Figure 1B) and on 123I-metaiodobenzylguanidine (MIBG) scintigraphy in the right adrenal gland (Figure 1C).
case_images: Body temperature (BT) and C-reactive protein (CRP) level before and after treatment. mPSL, methylprednisolone pulse therapy; NSAIDs, nonsteroidal anti-inflammatory drugs.
case_images: cureus-0016-00000052760-i02.jpg
case_images: PMC10882191_01_cureus-0016-00000052760-i02.jpg
case_images: FIG2
case_images: Therefore, prednisolone was started 15 days after admission, which subsequently promoted the complete resolution of her fever (Figure 2).
case_images: Immunostaining images of the tumor specimen. (A): H&E staining of the resected tissue (x400). (B): Chromogranin A immunostaining of the resected tissue (x400). Tumor cells were focally positive for chromogranin A. (C): Synaptophysin immunostaining of the resected tissue (x400). Immunostaining showed positive results in the resected tissue.
case_images: cureus-0016-00000052760-i03.jpg
case_images: PMC10882191_01_cureus-0016-00000052760-i03.jpg
case_images: FIG3
case_images: The tumor cells had granular cytoplasm and were immunohistochemically positive for chromogranin A, and synaptophysin (Figure 3).
case_images: IL-6 secretion determined via enzyme-linked immunosorbent assay. Enzyme-linked immunosorbent assay revealed increased IL-6 secretion in the current case. #1, the current case; #2, 3, the other cases.
case_images: cureus-0016-00000052760-i04.jpg
case_images: PMC10882191_01_cureus-0016-00000052760-i04.jpg
case_images: FIG4
case_images: This patient exhibited more IL-6 secretion than that seen in other cases (Figure 4).
case_images: IL-6 and STAT3 expressions in resected specimens. (A): The relative IL-6 mRNA level exceeded that in the other controls. (B): The relative STAT3 mRNA level exceeded that in the other controls. (C): The images show the immunoblot results and graphical quantification for STAT3 and beta-actin. #1, this case; #2, 3, the other cases. The asterisk indicates a significant difference (p < 0.05).. STAT, signal transducer and activator of transcription; mRNA: messenger RNA.
case_images: cureus-0016-00000052760-i05.jpg
case_images: PMC10882191_01_cureus-0016-00000052760-i05.jpg
case_images: FIG5
case_images: Similarly, phospho-STAT3 protein expression was higher than in the other cases (Figure 5).