直肠癌双侧肾上腺转移导致肾上腺功能衰竭：一例报告。
Adrenal failure due to bilateral adrenal metastasis of rectal cancer: A case report.
作者信息
Imaoka Yuki, Kuranishi Fumito, Ogawa Yoshiteru, Okuda Hiroshi, Nakahara Masahiro
机构信息
Department of Surgery, Innoshima Ishikai Hospital, 1962, Nakanosho, Innoshima, Onomichi, 722-7221, Japan.
Department of Surgery, Onomichi General Hospital, 1-10-23, Hirahar, Onomich, 722-8508, Japan.
出版信息
Int J Surg Case Rep. 2017;31:1-4. doi: 10.1016/j.ijscr.2016.12.011. Epub 2016 Dec 21.
INTRODUCTION
It is rare for a patient to present with adrenal insufficiency secondary to bilateral adrenal metastases from a malignant colorectal tumor.
CASE PRESENTATION
An 82-year-old Japanese man presented to our hospital with high fever and malaise. He was receiving oral chemotherapy for the treatment of rectal cancer with multiple metastases. Computed tomography showed new bilateral adrenal gland metastases. A rapid adrenocorticotropic hormone (ACTH) test showed adrenal insufficiency. Treatment with hydrocortisone provided immediate symptom improvement.
DISCUSSION
Adrenal insufficiency secondary to bilateral adrenal metastases from rectal cancer is rare. A rapid ACTH test is useful to diagnose adrenal insufficiency.
CONCLUSION
The incidence of adrenal insufficiency may be underestimated in patients with multiple metastasis. Appropriate therapy with adrenal corticosteroid hormone supplementation may lead to a significant improvement in the patient's symptoms and quality of life.
引言
因恶性结直肠癌双侧肾上腺转移继发肾上腺功能不全的患者较为罕见。
病例报告
一名82岁的日本男性因高热和不适前来我院就诊。他正在接受口服化疗以治疗多发转移的直肠癌。计算机断层扫描显示双侧肾上腺出现新的转移灶。快速促肾上腺皮质激素（ACTH）试验显示肾上腺功能不全。氢化可的松治疗使症状迅速改善。
讨论
直肠癌双侧肾上腺转移继发肾上腺功能不全较为罕见。快速ACTH试验有助于诊断肾上腺功能不全。
结论
多发转移患者肾上腺功能不全的发生率可能被低估。适当补充肾上腺皮质激素治疗可能会显著改善患者症状和生活质量。
Zotero 插件