The Aga Khan University Hospital Main Campus Karachi, Karachi, Pakistan.
Tabba Heart Institute, Karachi, Pakistan
BMJ Case Rep. 2022 May 11;15(5):e248607. doi: 10.1136/bcr-2021-248607.
In this case report, we present a case of a woman in her late 30s who presented with bilateral motor weakness, headache, hyperglycaemia and hypertension. Investigations revealed very high 24-hour urine cortisol of 90 524, ectopic adrenocorticotropic hormone secreting pheochromocytoma, normal metanephrine levels and empty sella, which has never been reported. CT chest and abdomen revealed enlarged left adrenal gland with large necrotic mass 4.7×4.0 cm most likely neoplastic lesion. The patient was cured after surgical removal of the left adrenal mass. Histological examination revealed 3.5×2.5×2 cm mass consistent with pheochromocytoma. After surgery and a short stay in the intensive care unit, the patient started improving and both antihypertensive treatment and insulin injections were withdrawn.
在本病例报告中，我们介绍了一位 30 多岁的女性患者，她表现为双侧运动无力、头痛、高血糖和高血压。检查发现 24 小时尿皮质醇非常高，达到 90 524，异位促肾上腺皮质激素分泌的嗜铬细胞瘤，正常的间甲肾上腺素水平和空蝶鞍，这在以前从未报道过。胸部和腹部 CT 显示左肾上腺增大，有 4.7×4.0cm 大的坏死肿块，很可能是肿瘤病变。患者在切除左肾上腺肿块后痊愈。组织学检查显示 3.5×2.5×2cm 的肿块符合嗜铬细胞瘤。手术后，患者在重症监护病房住了很短一段时间，开始好转，降压治疗和胰岛素注射都停止了。
