Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a history of progressive weight gain, central obesity, and supraclavicular fat pads. Reports easy bruising, proximal muscle weakness, and recent onset of secondary hypertension. Notable for menstrual irregularities (in females) or decreased libido (in males). No history of exogenous corticosteroid use.
Clinical Examination Findings
Physical exam reveals moon facies, buffalo hump, and abdominal striae (violaceous, >1cm). Skin is thin with ecchymoses noted on extremities. Blood pressure is elevated. Proximal myopathy noted on motor testing. No peripheral edema.
Treatment Protocol
Surgical intervention: Adrenalectomy (laparoscopic preferred) indicated for confirmed adrenal adenoma. Pre-operative optimization includes blood pressure control and electrolyte correction. Post-operative management requires glucocorticoid replacement therapy due to HPA axis suppression.