Studies in a Patient with an Ectopic Adrenocortical Tumor

A patient is described who continued to have Cushing's syndrome following bilateral adrenalectomy. The possibility that he was taking exogenous cortisol was excluded. Repeated studies of adrenocortical function suggested the presence of an adrenocortical neoplasm in an ectopic site. Blood samples obtained from the inferior vena cava demonstrated an abrupt increase in the concentration of plasma 17-OHCS at the level of the first lumbar vertebra. An adrenocortical carcinoma was subsequently found above the upper pole of the right kidney and was removed.