Martínez García R, Martínez Pérez A, Domingo del Pozo C, Sospedra Ferrer R
General and Digestive Surgery Department, Universitary Hospital Doctor Peset, Avda. Gaspar Aguilar 90, 46017, Valencia, Spain.
J Endocrinol Invest. 2016 Mar;39(3):273-6. doi: 10.1007/s40618-015-0345-0. Epub 2015 Jul 23.
Cushing's syndrome (CS) is a rare disease in pregnancy and its differential diagnosis is complicated. It is usually confused with complicated pregnancy cases, such us preeclampsia and gestational diabetes. This usually leads to a delayed diagnosis and is also associated with severe materno-foetal complications.
We present a case of a pregnant woman in her third trimester of pregnancy with CS secondary to an adrenal adenoma without response to medical treatment who underwent laparoscopic adrenalectomy without complications.
Most authors consider adrenalectomy as the first-choice treatment, since it presents higher rate of successful pregnancies. However, previously published cases did not reflect this stance. These publications prefer to maintain medical treatment, allowing pregnancy to go to term and delaying adrenalectomy after childbirth. We consider that experience in laparoscopic surgery, obstetric knowledge and resources now available, all offer sufficient guarantees to carry out the laparoscopic procedure to treat CS in pregnancy even in the third trimester. Laparoscopic adrenalectomy for CS in pregnancy is a safe and efficacious procedure allowing stopping the disease and curbing the dreadful consequences it may have for both mother and foetus.
库欣综合征（CS）在孕期是一种罕见疾病，其鉴别诊断较为复杂。它通常与复杂的妊娠情况相混淆，如先兆子痫和妊娠期糖尿病。这通常会导致诊断延迟，并且还与严重的母婴并发症相关。
我们报告一例妊娠晚期孕妇，患有继发于肾上腺腺瘤的库欣综合征，药物治疗无效，接受了腹腔镜肾上腺切除术，且无并发症。
大多数作者认为肾上腺切除术是首选治疗方法，因为其成功妊娠率较高。然而，先前发表的病例并未反映出这一立场。这些出版物倾向于维持药物治疗，让妊娠足月，并在产后延迟肾上腺切除术。我们认为，目前腹腔镜手术的经验、产科知识和可用资源，都为在孕期甚至妊娠晚期开展腹腔镜手术治疗库欣综合征提供了充分保障。孕期腹腔镜肾上腺切除术治疗库欣综合征是一种安全有效的手术，能够控制疾病并遏制其对母亲和胎儿可能产生的可怕后果。
