Kemink S A, Wesseling P, Pieters G F, Verhofstad A A, Hermus A R, Smals A G
Dept of Endocrinology, University Hospital Nijmegen, The Netherlands.
J Endocrinol Invest. 1999 Jan;22(1):70-5. doi: 10.1007/BF03345482.
A 25-year-old woman developed Nelson's syndrome, 3 years after successful bilateral adrenalectomy for Cushing's disease. Despite pituitary surgery and radiotherapy the tumour showed invasive growth, leading to visual disturbance, paresis of the oculomotor nerve and, 34 years after adrenalectomy, to death by widespread purulent leptomeningitis. Autopsy revealed a large adenohypophyseal carcinoma with a metastasis attached to the dura, both tumours showing immunocytochemical staining for ACTH and TSH. We review the literature on metastatic adenohypophyseal carcinoma in Cushing's disease and Nelson's syndrome and discuss the role of proliferation markers as indicators of malignant progression.
一名25岁女性在因库欣病成功进行双侧肾上腺切除术后3年发生了纳尔逊综合征。尽管接受了垂体手术和放疗，但肿瘤仍呈侵袭性生长，导致视力障碍、动眼神经麻痹，并在肾上腺切除术后34年因广泛的化脓性软脑膜炎死亡。尸检发现一个大的腺垂体癌，硬脑膜上有一个转移灶，两个肿瘤均显示促肾上腺皮质激素（ACTH）和促甲状腺激素（TSH）的免疫细胞化学染色阳性。我们回顾了关于库欣病和纳尔逊综合征中转移性腺垂体癌的文献，并讨论了增殖标志物作为恶性进展指标的作用。
