Suzuki N, Kobayashi Y, Yasuhara K, Sakai S, Kitamura Y, Tanaka M, Sugiyama M, Masai M, Shimazaki J
Department of Urology, Kounodai Hospital.
Nihon Hinyokika Gakkai Zasshi. 1993 Nov;84(11):2027-30. doi: 10.5980/jpnjurol1989.84.2027.
A 67-year-old man was admitted to the orthopedic ward, complaining of severe pain in his right greater trochanter. He was diagnosed as spinal cord tumor and underwent laminectomy for extirpation of the tumor. Histological examination revealed bone metastasis of unknown origin. Laboratory data revealed hypokalemia and hyperglycemia. Endocrinological data showed elevation of plasma cortisol and ACTH, and increased excretion of urinary 17-OHCS. Ten specimens needle biopsy of the prostate showed poorly differentiated adenocarcinoma, thus patient was diagnosed as prostate cancer with bone metastasis (stage D2) and perhaps ectopic ACTH production. Castration was performed, however 2 days after the surgery he died suddenly. We suspected that cerebral hemorrhage was the cause of his death. On autopsy ectopic ACTH production in the prostate was confirmed.
一名67岁男性因右大转子剧痛入住骨科病房。他被诊断为脊髓肿瘤并接受了椎板切除术以切除肿瘤。组织学检查显示为不明来源的骨转移。实验室检查数据显示低钾血症和高血糖。内分泌学检查数据显示血浆皮质醇和促肾上腺皮质激素升高,尿17-羟皮质类固醇排泄增加。前列腺穿刺活检的十份标本显示为低分化腺癌,因此该患者被诊断为前列腺癌伴骨转移(D2期),可能存在异位促肾上腺皮质激素分泌。患者接受了去势手术,但术后两天突然死亡。我们怀疑脑出血是其死亡原因。尸检证实前列腺存在异位促肾上腺皮质激素分泌。