Ishikawa Motoko, Kato Masako, Sasaki Hiroshi, Morii Tsukasa, Fujita Hiroki, Kakei Masafumi, Narita Takuma, Yamada Yuichiro
Department of Endocrinology, Diabetes and Geriatric Medicine, Akita University Graduate School of Medicine, Japan.
Intern Med. 2015;54(6):617-20. doi: 10.2169/internalmedicine.54.2782. Epub 2015 Jan 15.
A 48-year-old woman diagnosed with acromegaly 21 years earlier presented at our hospital with a left adrenal tumor. Her medical history included breast cancer, thyroid cancer and an incompletely resected growth hormone (GH)-producing pituitary adenoma. Endocrinological and radiological examinations revealed subclinical adrenal Cushing's syndrome. She subsequently underwent left adrenalectomy, followed by glucocorticoid replacement therapy. Her GH and insulin-like growth factor-1 levels were insufficiently controlled, and pegvisomant was administered in addition to octreotide acetate. Following adrenalectomy, a giant hepatic hemangioma and papillary thyroid carcinoma in the residual right lobe developed, indicating the high risk of tumor development in patients with acromegaly.
一名21年前被诊断为肢端肥大症的48岁女性因左肾上腺肿瘤前来我院就诊。她的病史包括乳腺癌、甲状腺癌以及未完全切除的分泌生长激素（GH）的垂体腺瘤。内分泌和影像学检查显示为亚临床肾上腺库欣综合征。她随后接受了左肾上腺切除术，接着进行糖皮质激素替代治疗。她的GH和胰岛素样生长因子-1水平控制不佳，除醋酸奥曲肽外还使用了培维索孟。肾上腺切除术后，残留右叶出现巨大肝血管瘤和甲状腺乳头状癌，这表明肢端肥大症患者发生肿瘤的风险很高。
