Oliaro A, Filosso P L, Casadio C, Ruffini E, Mazza E, Molinatti M, Cianci R, Porrello C, Rastelli M, Oliveri F
Department of Thoracic Surgery, University of Turin, Italy.
J Cardiovasc Surg (Torino). 1995 Oct;36(5):511-4.
Bronchial carcinoid is the most frequent cause of Cushing's syndrome due to ectopic ACTH production. The authors report a case of bronchial carcinoid which diagnosis was difficult because of the presence of pulmonary mycosis, that determined a hypercorticosuprarenalism. Medical treatment with octreotide, ketoconazolo and mitotane was useless, and bilateral suprarenalectomy was performed. A scintigraphy with raced somatostatin revealed a left lung area capting radiation. A CT scan of the thorax revealed a lesion of the lingula and the patient underwent an atypical lung resection with complete solution of the symptom. The problems of diagnosis and treatment of neuroendocrine tumors of the lung are discussed and the importance of SSA in the diagnostic procedure is pointed out.
支气管类癌是异位促肾上腺皮质激素(ACTH)分泌导致库欣综合征最常见的病因。作者报告了一例支气管类癌病例,由于存在肺部真菌病,导致诊断困难,进而引发了肾上腺皮质功能亢进。使用奥曲肽、酮康唑和米托坦进行药物治疗无效,遂行双侧肾上腺切除术。用消旋生长抑素进行的闪烁扫描显示左肺区域有放射性摄取。胸部CT扫描显示舌叶有病变,患者接受了非典型肺切除术,症状完全缓解。文中讨论了肺神经内分泌肿瘤的诊断和治疗问题,并指出生长抑素类似物(SSA)在诊断过程中的重要性。