Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, 107 Wenhuaxi Road, Ji'nan, Shandong, 250012, People's Republic of China.
Radiology Departments, Qilu Hospital, Shandong University, 107 Wenhuaxi Road, Ji'nan, Shandong, 250012, People's Republic of China.
BMC Pregnancy Childbirth. 2020 Jan 21;20(1):50. doi: 10.1186/s12884-020-2737-1.
Pregnancy complicated with adrenocortical carcinoma (ACC) is a sporadic syndrome that is characterized by hypertension, uncontrolled hypokalemia, severe heart failure, premature delivery and other adverse effects. The clinical presentation of adrenocortical carcinoma is vague and nonspecific, it is challenging to identify complications of pregnancy with adrenocortical carcinoma. Here we present a case of adrenocortical carcinoma during pregnancy. We describe how to distinguish secondary hypertension from other conditions and the importance of timely detection and treatment of such patients.
A 22-year-old woman 30 weeks pregnant was hospitalized with uncontrolled hypertension and hypokalemia. An ultrasound examination of the right adrenal gland revealed a large mass. She underwent transabdominal adrenalectomy, and histopathology from the sample removed revealed an adrenocortical carcinoma. Five days after surgery, the patient had a premature rupture of the fetal membranes and gave birth to a newborn girl via vaginal delivery at 32 weeks of gestation. The newborn was transferred to the neonatal pediatrics ward, and the woman started receiving chemotherapy.
Pregnancy with adrenocortical carcinoma is a rare condition. This case alerts the obstetricians that analysis of hypertension, hypokalemia, the plasma level and circadian rhythm of plasma cortisol provides a strategy to diagnose adrenocortical carcinoma during pregnancy.
妊娠合并肾上腺皮质癌（adrenocortical carcinoma，ACC）是一种散发性综合征，其特征为高血压、低钾血症无法控制、严重心力衰竭、早产和其他不良反应。肾上腺皮质癌的临床表现模糊且非特异性，因此难以识别妊娠合并肾上腺皮质癌的并发症。本文报告 1 例妊娠合并肾上腺皮质癌病例。我们描述了如何将继发性高血压与其他情况区分开来，以及及时发现和治疗此类患者的重要性。
一名 22 岁、妊娠 30 周的女性因无法控制的高血压和低钾血症住院。对右肾上腺的超声检查显示有一个大肿块。她接受了经腹肾上腺切除术，切除样本的组织病理学检查显示为肾上腺皮质癌。术后 5 天，患者胎膜早破，并于妊娠 32 周经阴道分娩出一名女婴。新生儿转至新生儿儿科病房，该女性开始接受化疗。
妊娠合并肾上腺皮质癌较为罕见。该病例提醒妇产科医生，对高血压、低钾血症、血浆皮质醇水平和昼夜节律进行分析，为妊娠期间诊断肾上腺皮质癌提供了策略。
