CUSHING SYNDROME ASSOCIATED WITH DISSECTING ANEURYSM : REPORT OF A CASE TREATED SURGICALLY

Adrenectomy and grafting of the ascending aorta were successfully performed in a 44-year-old woman with Cushing syndrome associated with a DeBakey type I dissecting aneurysm. The patient, who had hypertension, complained of sudden of pain attacks in her anterior chest. A DeBakey type I dissecting aneurysm was diagnosed by thoracal CT scans. During the period of conservative therapy with antihypertensive agents, a mass on her left adrenal gland was detected by abdominal CT scans. Endocrinological and functional examinations suggested Cushing syndrome caused by an adrenal adenoma. First, the ascending aorta was replaced with a 24-mm woven Dacron graft under cardiopulmonary bypass. Six weeks later, a left adrenal tumor was removed under a posterolateral approach. Her postoperative course was uneventful with good control of her blood pressure. Pathological findings for the resected tumor confirmed a benign cortical adenoma. To our knowledge, Cushing syndrome associated with a dissecting aneurysm has not been previously reported.