![]() Because of the overproduction of cortisol from the tumour, the patient's otherwise healthy left adrenal gland had reduced its cortisol production to a level that would have been too low to supply the body's cortisol needs immediately after the tumour removal. ![]() The patient then had an operation to remove both the right adrenal gland and the cancer. ![]() The adenoma was producing cortisol and this was blocked for six weeks, with the drug metyrapone (Metopirone), to allow the tissues to recover from Cushing's syndrome and to improve wound healing. Examination of the patient by the author revealed clinical signs of Cushing's syndrome, which was subsequently confirmed by biochemical tests. This was a chance discovery when the patient had scans because of jaundice due to a small cancer of the opening of the bile duct from the liver. The arrow shows a lump in the right adrenal gland. ![]() It is presented as if looking up from the patient's feet, so the spine is in the lower middle of the picture and right and left are transposed. In this MRI scan the image cuts through the abdomen at the level of the adrenal glands, just above the kidneys.
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