Endo Case Challenge: Amenorrhea for Months, Mood Swings, Weight Gain in a 38-Year-Old Woman

Benjamin Scott Harris, MD, MPH; Thomas Michael Price, MD


September 13, 2022

Benign tumors that are hormonally active should be treated with adrenalectomy. Medical management may be indicated if surgery is contraindicated, but care should be taken to avoid overtreatment, which can lead to adrenal insufficiency.

This patient had an interesting case of Cushing syndrome, with an initial presentation for infertility evaluation, which made the diagnosis challenging. Her clinical presentation highlights the importance of a comprehensive history, physical examination, and endocrine laboratory evaluation for patients with irregular menstrual cycles. Extended evaluation was performed after identification of an abnormally low DHEA-S level. If the DHEA-S test had not been performed, an opportunity for treatment and cure would have been missed. She underwent a unilateral adrenalectomy and subsequently proceeded with fertility treatment.


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