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双侧肾上腺出血预示着支气管源性癌。

Bilateral Adrenal Hemorrhage Heralds Bronchogenic Carcinoma.

作者信息

Azani Faysal, Alozai Abdur Rehman, William Jimmy, Sharma Jayant

机构信息

Cardiology, Sligo University Hospital, Sligo, IRL.

Internal Medicine, Royal Preston Hospital, Preston, GBR.

出版信息

Cureus. 2024 Jan 11;16(1):e52109. doi: 10.7759/cureus.52109. eCollection 2024 Jan.

Abstract

This case study delves into the unusual presentation of non-small cell lung carcinoma (NSCLC), where bilateral hemorrhagic adrenal metastasis served as the primary indication of an underlying malignancy. Our patient, a 58-year-old male, sought medical attention due to acute abdominal pain and lower back discomfort, leading to an in-depth diagnostic exploration. Radiological examinations revealed bilateral adrenal masses exhibiting hemorrhagic characteristics, a distinctive feature not commonly associated with NSCLC. The subsequent biopsy and histopathological analysis definitively identified metastatic NSCLC as the culprit. The uniqueness of this case lies in the bilateral nature of the metastasis and the presence of hemorrhagic elements, challenging traditional diagnostic expectations. This report emphasizes the necessity for a nuanced approach to diagnostic investigations when confronted with atypical presentations, especially considering the rarity of bilateral involvement and hemorrhagic features in adrenal metastases from NSCLC. It highlights the importance of interdisciplinary collaboration between radiologists, pathologists, and oncologists to ensure accurate and timely diagnosis. The overarching significance of this case extends beyond its rarity; it underscores the imperative for healthcare practitioners to broaden their diagnostic considerations in the absence of conventional symptoms. By presenting this distinctive case, we contribute to the evolving understanding of the diverse clinical manifestations of NSCLC, advocating for heightened vigilance and comprehensive diagnostic approaches in the pursuit of early intervention and optimal patient care.

摘要

本病例研究深入探讨了非小细胞肺癌(NSCLC)的异常表现,其中双侧出血性肾上腺转移是潜在恶性肿瘤的主要指征。我们的患者是一名58岁男性,因急性腹痛和下背部不适就医,从而引发了深入的诊断探索。影像学检查显示双侧肾上腺肿块具有出血特征,这是NSCLC通常不具备的显著特征。随后的活检和组织病理学分析明确将转移性NSCLC确定为病因。该病例的独特之处在于转移的双侧性以及出血成分的存在,这挑战了传统的诊断预期。本报告强调,面对非典型表现时,尤其是考虑到NSCLC肾上腺转移中双侧受累和出血特征的罕见性,诊断调查需要采取细致入微的方法。它突出了放射科医生、病理科医生和肿瘤内科医生之间跨学科协作以确保准确及时诊断的重要性。该病例的总体意义不仅在于其罕见性;它强调了医疗从业者在缺乏传统症状时扩大诊断考量范围的必要性。通过展示这个独特病例,我们有助于增进对NSCLC多样临床表现的理解,倡导在追求早期干预和最佳患者护理过程中提高警惕并采用全面的诊断方法。

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