Kojima Yuta, Kamimura Noritaka, Yamamoto Hayato, Murasawa Hiromi, Okamoto Akiko, Imai Atsushi, Hatakeyama Shingo, Yoneyama Takahiro, Hashimoto Yasuhiro, Koie Takuya, Ohyama Chikara
The Department of Urology, Hirosaki University Graduate School of Medicine, Japan.
Hinyokika Kiyo. 2013 Jul;59(7):419-22.
A 22-year-old man was referred to our hospital because of facial edema and increasing body weight. Under the diagnosis of Cushing syndrome due to an adrenocorticotropic (ACTH)-producing thyroid tumor, thyroidectomy with regional lymph node dissection was performed. Histopathological diagnosis was thyroid carcinoid. In spite of the operation, serum ACTH and cortisol concentrations increased again due to mediastinal lymph node metastasis. His hyper-cortisolemia was resistant to drug therapy. Then, laparoscopic bilateral adrenalectomy was performed. After the operation, hyper-cortisolemia and clinical symptoms markedly improved. An additional chemotherapy is implemented because of new metastasis in the mediastinum lymph nodes.
一名22岁男性因面部水肿和体重增加被转诊至我院。诊断为促肾上腺皮质激素（ACTH）分泌性甲状腺肿瘤所致库欣综合征，遂行甲状腺切除术及区域淋巴结清扫术。组织病理学诊断为甲状腺类癌。尽管进行了手术，但由于纵隔淋巴结转移，血清ACTH和皮质醇浓度再次升高。他的高皮质醇血症对药物治疗耐药。随后，进行了腹腔镜双侧肾上腺切除术。术后，高皮质醇血症及临床症状明显改善。因纵隔淋巴结出现新的转移灶，遂实施了辅助化疗。
