Case Report: ACTH-independent Cushing’s syndrome caused by isolated micronodular adrenal disease in a 23-month-old girl - Takeaways - MDSpire

Case Study: Isolated Micronodular Adrenal Disease Leading to ACTH-Independent Cushing’s Syndrome in a 23-Month-Old Female Patient

  • By

  • Marta Valério

  • Gonçalo P. Croca

  • Joana Simões

  • Patricia Ferreira

  • Durval C. Costa

  • Maria Knoblich

  • Julia Galhardo

  • July 21, 2026

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  • 1

    A 23-month-old girl presented with symptoms of Cushing’s syndrome, including rapid weight gain, hypertension, and developmental regression.

  • 2

    Biochemical tests confirmed ACTH-independent hypercortisolism, with suppressed ACTH and increased urinary free cortisol.

  • 3

    Adrenal imaging showed normal glands, but scintigraphy indicated bilateral adrenal uptake, leading to a right adrenalectomy.

  • 4

    Histopathological examination revealed isolated micronodular adrenal disease without malignancy, consistent with the diagnosis.

  • 5

    Post-surgery, the patient showed significant improvement in symptoms and required minimal steroid supplementation, with no signs of recurrent hypercortisolism.

Original Source(s)

Case Report: ACTH-independent Cushing’s syndrome caused by isolated micronodular adrenal disease in a 23-month-old girl

  • by Marta Valério, Gonçalo P. Croca, Joana Simões, Patricia Ferreira, Durval C. Costa, Maria Knoblich, Julia Galhardo

  • July 21, 2026

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