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生长抑素受体阴性和氟脱氧葡萄糖正电子发射断层扫描阳性肺神经内分泌肿瘤 G1 表现为周期性库欣综合征。

Somatostatin Receptor-negative and Fluorodeoxyglucose-positron Emission Tomography-positive Lung Neuroendocrine Tumor G1 Exhibiting Cyclic Cushing's Syndrome.

机构信息

Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medical Sciences, Japan.

Department of Diabetes, Endocrinology and Metabolism, Koseiren Takaoka Hospital, Japan.

出版信息

Intern Med. 2022 Dec 15;61(24):3693-3698. doi: 10.2169/internalmedicine.9238-21. Epub 2022 May 31.

Abstract

Localization of ectopic cyclic Cushing's syndrome, which causes life-threatening complications, is challenging. A 70-year-old woman showed cyclic hypokalemia and hyperglycemia and was diagnosed with cyclic ectopic Cushing's syndrome. Although somatostatin-receptor scintigraphy failed to localize the responsible tumor, fluorodeoxyglucose-positron emission tomography (FDG-PET) showed the uptake of tracer in a lung tumor. Lobectomy resulted in remission. The resected adrenocorticotropic hormone (ACTH)-producing neuroendocrine tumor had Ki-67<2% and negative staining for somatostatin receptors. This is the first case assessed both radiological findings and pathological findings in cyclic ectopic Cushing's syndrome. Subsequent FDG-PET is recommended if somatostatin-receptor scintigraphy is negative.

摘要

异位库欣综合征的定位具有挑战性,因为它会引起危及生命的并发症。一位 70 岁女性表现为周期性低钾血症和高血糖,被诊断为周期性异位库欣综合征。尽管生长抑素受体闪烁显像未能定位责任肿瘤,但氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)显示示踪剂在肺肿瘤中的摄取。肺叶切除术缓解了病情。切除的促肾上腺皮质激素(ACTH)产生的神经内分泌肿瘤 Ki-67<2%,且生长抑素受体染色阴性。这是首例评估周期性异位库欣综合征的影像学和病理学发现的病例。如果生长抑素受体闪烁显像为阴性,建议进行后续 FDG-PET 检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23d2/9841091/d38d606f64b0/1349-7235-61-3693-g001.jpg

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