Central Adrenal Insufficiency Developing After Right Partial Nephrectomy Involving Ectopic Adrenocortical Adenoma Mimicking Right Renal Carcinoma and a Retrospective Diagnosis of Adrenal Cushing's Syndrome: A Case Report

Introduction: Ectopic adrenocortical adenomas that produce adrenal hormones and mimic renal cell carcinoma are extremely rare. Case Presentation: A 49-year-old woman underwent partial nephrectomy of the upper pole of the kidney following a clinical diagnosis of renal cell carcinoma. The tumor, initially suspected to be renal cell carcinoma, was definitively diagnosed as an ectopic adrenocortical adenoma producing adrenocortical hormones, which was removed surgically. Postoperatively, she developed tertiary adrenal insufficiency. After hydrocortisone therapy, the patient's symptoms gradually improved, and laboratory results also showed improvement. Retrospectively, the patient exhibited signs of Cushing's syndrome. Conclusion: If the patient's body habitus suggests Cushing's syndrome, it is important to conduct an endocrinological evaluation before surgery. Additionally, early postoperative monitoring and glucocorticoid supplementation should be performed if necessary.