Approach to adrenal masses Quiz: Ace Your Exams

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A 42-year-old woman presents to the primary care clinic due to recent weight gain. Over the past year, the patient has unintentionally gained 20 lbs. (9.1 kg) with no change in diet or physical activity. She has also noticed increased fatigue, depressed mood, and irritability. She also mentions memory difficulties and feeling “foggy” lately. Temperature is 37.0ºC (98.6ºF), pulse is 84/min, respiratory rate is 16/min, and blood pressure is 154/85 mmHg. On physical examination, there is significant truncal obesity with apparent sarcopenia in the extremities. Violaceous striae are present on the abdomen. Muscle strength is 4/5 with hip flexion and extension bilaterally. Which of the following is the most probable cause of this patient’s symptoms?

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Benign adrenal adenoma

Adrenal malignancy

Pheochromocytoma

Cortisol-producing adrenal mass

Aldosterone-producing adrenal mass