Fan Changyan, Zhang Chenran, Shi Xiuhua, Bian Liuguan, Zhao Weiguo, Zhang Hua, Su Tingwei, Wang Weiqing, Li Xiaoying, Ning Guang, Kong Liang, Hu Lingling, Sun Qingfang
Department of Neurology, Wuxi No.3 People's Hospital, Wuxi, China.
Department of Neurosurgery, Shanghai Institute of Neurosurgery, Shanghai Changzheng Hospital, Shanghai, China.
Intractable Rare Dis Res. 2013 Feb;2(1):24-29. doi: 10.5582/irdr.2013.v2.1.24.
A 41-year-old female visited Ruijin Hospital because her face was swollen for more than 2 months. The patient was initially diagnosed with Cushing's disease (CD). Several examinations, including a dexamethasone suppression test (DST) at 2 mg and 8 mg, pituitary MRI, abdominal CT, punch biopsy of adrenal masses, and bilateral inferior petrosal sinus sampling (BIPSS), were performed, but the findings were not consistent with the clinical presentation. Ultimately, the patient underwent surgery and recovered. In this case, BIPSS was a useful way to diagnosis CD and suggested the exact location of a pituitary adenoma to Neurosurgery. BIPSS should be a required test for cases of CD that cannot be definitively diagnosed with just an MRI and 8 mg DST before surgery.
一名41岁女性因面部肿胀2个多月就诊于瑞金医院。该患者最初被诊断为库欣病（CD）。进行了多项检查，包括2毫克和8毫克地塞米松抑制试验（DST）、垂体磁共振成像（MRI）、腹部计算机断层扫描（CT）、肾上腺肿块穿刺活检以及双侧岩下窦采血（BIPSS），但检查结果与临床表现不符。最终，该患者接受手术并康复。在本病例中，BIPSS是诊断CD的一种有用方法，并为神经外科提示了垂体腺瘤的确切位置。对于术前仅通过MRI和8毫克DST不能明确诊断的CD病例，BIPSS应作为一项必要检查。
