Tamura Keita, Furuse Hiroshi, Sugiyama Takayuki, Kato Taiki, Suzuki Takahisa, Kai Fumitake, Nagata Masao, Otsuka Atsushi, Takayama Tatsuya, Ishii Yasuo, Mugiya Soichi, Ozono Seiichiro
Department of Urology, Hamamatsu University School of Medicine.
Nihon Hinyokika Gakkai Zasshi. 2013 Jan;104(1):17-21. doi: 10.5980/jpnjurol.104.17.
A 58-year-old man presented with nausea and left flank pain. The patient was referred to our hospital based on clear detection of anemia and computed tomography findings of bilateral adrenal tumors with hemorrhage and a mass in the apex of the left lung. Right adrenal artery embolization had no effect on enlargement of the right adrenal hematoma or advanced anemia. Right adrenalectomy was then performed in an attempt to control hemorrhaging and make a definitive diagnosis, and the patient's anemia improved following the operation. Histopathological diagnosis suggested adrenal metastasis of lung adenocarcinoma, which was subsequently diagnosed given similarities in transbronchial biopsy findings to those in the right adrenal gland. Adrenal hemorrhage due to metastasis of lung cancer is an extremely rare condition; indeed, to our knowledge, the present case is only the 26th reported worldwide. However, prognosis for this mortal condition may be improved should patients receive adrenalectomy followed by an appropriate treatment regimen.
一名58岁男性因恶心和左侧胁腹疼痛前来就诊。基于明确检测到的贫血以及计算机断层扫描显示的双侧肾上腺肿瘤伴出血和左肺尖部肿块，该患者被转诊至我院。右侧肾上腺动脉栓塞术对右侧肾上腺血肿增大或严重贫血并无效果。随后进行了右侧肾上腺切除术以控制出血并做出明确诊断，术后患者的贫血状况有所改善。组织病理学诊断提示为肺腺癌肾上腺转移，随后经支气管活检结果与右侧肾上腺相似而得以确诊。肺癌转移导致肾上腺出血是一种极为罕见的情况；据我们所知，本病例是全球第26例报道。然而，如果患者接受肾上腺切除术后再采用适当的治疗方案，这种致命疾病的预后可能会得到改善。
