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During menopause, plasma lipids change in an unfavourable way to a more atherogenic pattern, with increased total and LDLcholesterol and decreased HDL-cholesterol concentrations. Women with POI show increased cardiovascular morbidity and mortality regardless of the cause of the ovarian insufficiency. The treatment of premature ovarian failure in patients presenting extremely low HLD-C is a real challenge.

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Introduction:Adrenal carcinoma is a very rare malignancy accounting for 0.05-0.2% of all cancers(2), with an incidence 0.5-2/10 6 . Case presentation:We present the case of a 60 year old woman with impaired fasting glucose and hypertension, who was incidentally diagnosed, after a non-enhanced abdominal CT, with a right adrenal tumor of 4.5/6 cm. The mass was described as having smooth borders (Fig.1), and a heterogeneous aspect including solid parts, necrotic areas and 1 microcalcification (Fig.2) with no detection of local invasion or tumor extension. The CT scan was performed after a routine abdominal ultrasonography, that raised the suspicion of an adrenal tumor. Laboratory findings:• high fasting blood glucose (126/125 mg/dl) • low-normal ACTH (8.2 pg/mL, nv: 7.2-63.3)• normal morning serum cortizol (13.4 μg/dl, n.v.: 3.7-19.4) with insufficient suppresion after the over night and the two-day low dose dexamethasone tests (3.3/2.7 ug/dl)