Wanta Stephen M, Basina Marina, Chang Steven D, Chang Daniel T, Ford James M, Greco Ralph, Kingham Kerry, Merritt Robert E, Kunz Pamela L
Georgetown University School of Medicine, Washington, DC;
Rare Tumors. 2011 Oct 21;3(4):e45. doi: 10.4081/rt.2011.e45. Epub 2011 Dec 13.
We report a rare synchronous presentation of adrenocortical carcinoma (ACC) and papillary thyroid carcinoma (PTC). A 31-year-old male first presented with a large left adrenal mass that was identified during the workup for refractory hypertension due to hyperaldosteronism. The mass was removed surgically with pathology showing ACC. The patient was then treated with adjuvant radiation therapy and mitotane chemotherapy. Four months post ACC resection, metastatic ACC to the right upper lung and PTC in the left lobe of the thyroid were found in surveillance imaging. He subsequently developed pulmonary, contralateral adrenal and brain metastases from his ACC. Li Fraumeni syndrome and Multiple Endocrine Neoplasia Type I (MEN I) were considered, but testing of both P53 and menin genes showed no mutation. We also performed a review of the literature and found three similar cases, however gene mutation analysis was not performed..
我们报告了一例肾上腺皮质癌（ACC）和甲状腺乳头状癌（PTC）罕见的同步表现。一名31岁男性首次因原发性醛固酮增多症导致难治性高血压，在检查过程中发现左肾上腺有一个大肿块。该肿块经手术切除，病理显示为ACC。患者随后接受了辅助放疗和米托坦化疗。ACC切除术后四个月，在监测影像中发现右上肺转移性ACC和甲状腺左叶PTC。随后他的ACC出现了肺、对侧肾上腺和脑转移。考虑了李-佛美尼综合征和多发性内分泌腺瘤病I型（MEN I），但P53和menin基因检测均未发现突变。我们还对文献进行了回顾，发现了三例类似病例，但未进行基因突变分析。
