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隐匿性异位促肾上腺皮质激素分泌：诊断困境与感染后果

Occult ectopic adrenocorticotropic hormone secretion: diagnostic dilemma and infective consequence.

作者信息

Momah Njideka, Koroscil Thomas

机构信息

Wright State University, Dayton, OH, USA.

出版信息

Clin Pract. 2012 Nov 13;2(4):e82. doi: 10.4081/cp.2012.e82. eCollection 2012 Oct 12.

DOI:10.4081/cp.2012.e82
PMID:24765481
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3981195/
Abstract

A 42-year-old male presented with polyuria, polydipsia and weight loss. His initial physical exam showed a paucity of cushingoid features. Diagnostic work up was consistent with an ectopic adrenocorticotropic hormone (ACTH) secretion. Imaging studies showed a small anterior mediastinal lesion without additional metabolically active tumors. Fine needle aspiration was consistent with a thymic neuroendocrine tumor. Following radical thymectomy, plasma ACTH and cortisol levels remained elevated. Despite medical management, he died within 2 months of presentation of disseminated intracranial aspergillosis. This case underscores the diagnostic dilemma of occult ectopic ACTH-secreting tumors and the fatal consequence of opportunistic infections.

摘要

一名42岁男性出现多尿、多饮和体重减轻症状。其初次体格检查显示库欣样特征不明显。诊断性检查结果与异位促肾上腺皮质激素（ACTH）分泌相符。影像学研究显示前纵隔有一个小病变，未发现其他代谢活跃肿瘤。细针穿刺结果与胸腺神经内分泌肿瘤相符。根治性胸腺切除术后，血浆ACTH和皮质醇水平仍升高。尽管进行了药物治疗，但他在出现播散性颅内曲霉菌病后2个月内死亡。该病例凸显了隐匿性异位ACTH分泌肿瘤的诊断困境以及机会性感染的致命后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3f5/3981195/e1ec2cec3740/cp-2012-4-e82-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3f5/3981195/b7c1292a673a/cp-2012-4-e82-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3f5/3981195/5fc1debc39df/cp-2012-4-e82-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3f5/3981195/4ee72040534e/cp-2012-4-e82-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3f5/3981195/e1ec2cec3740/cp-2012-4-e82-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3f5/3981195/b7c1292a673a/cp-2012-4-e82-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3f5/3981195/5fc1debc39df/cp-2012-4-e82-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3f5/3981195/4ee72040534e/cp-2012-4-e82-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3f5/3981195/e1ec2cec3740/cp-2012-4-e82-g004.jpg

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本文引用的文献

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