Azuma H, Okada S, Fukuhara M, Inoue H, Shimizu A, Takasaki N
Department of Urology, Osaka Medical School.
Hinyokika Kiyo. 1991 Mar;37(3):259-61.
A 24-year-old man visited our hospital complaining of hypertension and headache. Endocrinological findings revealed no abnormalities except for a slight decrease in serum adrenocorticotropic hormone (ACTH), a slight increase in urine 17-ketosteroid (17-KS), and a marked increase in serum pregnenolone. Computed tomography and magnetic resonance imaging revealed a 3 x 3 cm mass in the right adrenal area and I131-aldosterol scintigraphy demonstrated a high absorption of the isotope in the right adrenal area. Vena cavography suggested a 2 x 2 cm tumor thrombus originating in the right adrenal. Under the diagnosis of the right adrenocortical carcinoma, adrenalectomy and removal of the tumor thrombus were performed. Both serum pregnenolone and urine 17-KS returned to the normal level within a week after the operation and blood pressure was well controlled without any medication 3 months after the operation. Thus, the tumor seemed to be endocrinologically active.
一名24岁男性因高血压和头痛前来我院就诊。内分泌检查结果显示，除血清促肾上腺皮质激素（ACTH）略有下降、尿17-酮类固醇（17-KS）略有升高以及血清孕烯醇酮显著升高外，无其他异常。计算机断层扫描和磁共振成像显示右肾上腺区域有一个3×3厘米的肿块，I131-醛固酮闪烁显像显示右肾上腺区域对该同位素摄取较高。腔静脉造影提示起源于右肾上腺的一个2×2厘米的肿瘤血栓。在诊断为右肾上腺皮质癌后，进行了肾上腺切除术和肿瘤血栓清除术。术后一周内，血清孕烯醇酮和尿17-KS均恢复至正常水平，术后3个月血压无需任何药物即可得到良好控制。因此，该肿瘤似乎具有内分泌活性。
