El Aoud S, Tounsi H, Ben Ammou B, Chelbi E, Chaabène I, Ben Ahmed I, Amri R, Garbouj W, Bouzaidi K
Service de médecine interne, hôpital universitaire Mohamed-Taher-Maamouri, Mrazka, 8000 Nabeul, Tunisie.
Service de médecine interne, hôpital universitaire Mohamed-Taher-Maamouri, Mrazka, 8000 Nabeul, Tunisie.
Ann Cardiol Angeiol (Paris). 2019 Feb;68(1):56-60. doi: 10.1016/j.ancard.2018.08.022. Epub 2018 Oct 2.
Secondary hypertension is relatively rare. Its etiologies are essentially renal or endocrine. The adrenocortical carcinoma, a rare malignant tumor, is one of the most exceptional causes of hypertension. We report the case of a young woman presenting with hypertension and ascites of great abundance. She had hypokalemia, hepatic cytolysis and cholestasis. Thoracic, abdominal and pelvic CT scans showed adrenal mass, liver and lung nodules, osteolytic lesions of the sacrum. The biopsy of liver nodules confirmed the diagnosis of a metastatic malignant adrenocortical carcinoma. The hormonal investigations revealed cortisol and testosterone hypersecretion. The evolution was quickly fatal, the patient passed out a few days after her hospitalization.
继发性高血压相对少见。其病因主要为肾脏或内分泌方面。肾上腺皮质癌是一种罕见的恶性肿瘤，是高血压最特殊的病因之一。我们报告一例年轻女性，出现高血压及大量腹水。她有低钾血症、肝细胞溶解和胆汁淤积。胸部、腹部和盆腔CT扫描显示肾上腺肿块、肝脏和肺部结节、骶骨溶骨性病变。肝脏结节活检确诊为转移性恶性肾上腺皮质癌。激素检查显示皮质醇和睾酮分泌过多。病情进展迅速，患者住院几天后死亡。
