Adrenal cortical carcinoma Quiz: Ace Your Exams
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A 46-year-old man seeks evaluation for fatigue and “skin changes” that began 5 months ago. Past medical history is notable for hypertension and asthma. He is currently taking propranolol and uses a budesonide inhaler intermittently. The patient’s BMI is 35 kg/m2. His temperature is 37.2°C (99.0°F), blood pressure is 152/83 mmHg, pulse is 67/min, and respiratory rate is 15/min. Physical examination shows scattered ecchymoses and purple abdominal striae. There is symmetric muscle weakness in the upper and lower extremities. The patient also has deposition of fat on the back of his neck. The patient’s ACTH level is measured at 4 pg/mL (normal range: 5-20 pg/mL). Which of the following is the most likely explanation of the patient’s findings?
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