Case presentation A 43-year-old man presented with skin hyperpigmentation involving oral and lip mucous membranes. The patient also reported nausea, fatigue, weight loss, decreased appetite, abdominal pain, and joint pain. Medical examination Cardiac, respiratory, abdominal, and neurologic examinations were normal.
Laboratory investigations Serum cortisol < 0.05 mcg/dl (Normal range: 3.09–16.6 mcg/dL) Mantoux test: Negative Interferon Gamma Release Assay (IGRA) test: Negative Imaging evaluation An upper abdominal MRI showed bilateral adrenal hyperplasia and hypertrophy. Laparoscopic findings The laparoscopic adrenalectomy revealed multiple caseosa necrosis in the gross specimen and Datia-Langhans cell. *This case is from the Editorial team of Docplexus and is meant for educational purposes only.
