Siddiqui Nadir, Khan Bilal Ahmed
Jinnah Postgraduate Medical Center, Karachi.
J Pak Med Assoc. 2018 Aug;68(8):1267-1269.
28 years old, male patient was diagnosed with Metastatic Adrenocortical Carcinoma after extensive investigation. Patient's primary concern was only his right hip and right shoulder pain. On imaging investigations, the patient was diagnosed with Avascular Necrosis of the right hip joint. Further laboratory work-up for avascular necrosis showed Primary Hypercortisolism and eventually patient was found to have Adrenocortical Carcinoma base on CT and bone scan results, Avascular Necrosis usually presents with pain in the affected area, mostly involving shoulder, knee or hip joint. Among many of the causes of Avascular necrosis, one rare cause is hormone secreting Adreno cortical Carcinoma, a rare and a highly malignant tumour. Patients can present with Cushing's syndrome or can have atypical presentation like this patient. This patient did not have any symptoms related to malignancy such as loss of appetite and weight loss.
一名28岁男性患者在经过广泛检查后被诊断为转移性肾上腺皮质癌。患者主要关心的只是他的右髋部和右肩部疼痛。经影像学检查，该患者被诊断为右髋关节缺血性坏死。针对缺血性坏死的进一步实验室检查显示原发性皮质醇增多症，最终根据CT和骨扫描结果发现患者患有肾上腺皮质癌。缺血性坏死通常表现为受累部位疼痛，主要累及肩部、膝关节或髋关节。在缺血性坏死的众多病因中，一种罕见的病因是分泌激素的肾上腺皮质癌，这是一种罕见且高度恶性的肿瘤。患者可能表现为库欣综合征，也可能像该患者一样有非典型表现。该患者没有任何与恶性肿瘤相关的症状，如食欲不振和体重减轻。
