Singer F
Department of Medicine, Harlem Hospital Center, College of Physicians and Surgeons of Columbia University, New York, New York.
Obstet Gynecol. 1991 Sep;78(3 Pt 2):569-70.
A 63-year-old woman presented with a 3-day history of vaginal bleeding. Pelvic examination and ultrasound revealed bilateral atrophy of the ovaries and a uterus of 8.8 x 3.3 x 4.0 cm. Serum estradiol (E2) was 300 pg/mL. Cushing syndrome was diagnosed biochemically, and computed tomography of the abdomen revealed a 5-cm left adrenal mass and tumors in the liver and lung. A pathologic diagnosis of metastatic adrenal carcinoma was made after surgery. This case demonstrates that adrenal carcinoma can produce high E2 levels in a postmenopausal woman, leading to uterine enlargement and vaginal bleeding. Adrenal carcinoma should therefore be included in the differential diagnosis of postmenopausal vaginal bleeding.
一名63岁女性出现阴道出血3天。盆腔检查和超声显示双侧卵巢萎缩，子宫大小为8.8×3.3×4.0厘米。血清雌二醇（E2）为300 pg/mL。生化检查诊断为库欣综合征，腹部计算机断层扫描显示左肾上腺有一个5厘米的肿块，肝脏和肺部有肿瘤。手术后病理诊断为转移性肾上腺癌。该病例表明，肾上腺癌可在绝经后女性中产生高水平的E2，导致子宫增大和阴道出血。因此，肾上腺癌应纳入绝经后阴道出血的鉴别诊断。
