27th May 2025

Mr Stark is a 58-year-old man who was admitted with fatigue, weight loss, hypotension and electrolyte abnormalities and was diagnosed with adrenal crisis.

Mr Stark is a 58-year-old man who was admitted with fatigue, weight loss, hypotension and electrolyte abnormalities and was diagnosed with adrenal crisis. He improved with hydrocortisone infusions and fludrocortisone replacement. He had no significant past medical history, but a family history of hypothyroidism. An initial test for 21-hydroxylase antibodies was negative. A CT of the adrenals showed bilateral masses, however plasma and urine metanephrines were low. Which of the following are most likely to be responsible for the lesions?

Select the SINGLE most appropriate option from the list below. Select ONE option only.