Loh K C, Yap W M, Chia F K
Department of General Medicine, Tan Tock Seng Hospital, Singapore.
Singapore Med J. 1997 Jan;38(1):29-31.
A 17-year-old female with a large mass in the left thorax presenting with ectopic Cushing's syndrome is described. Biochemical evaluation revealed a corticotropin(ACTH)-dependent hypercortisol state. Surgical resection of the tumour resulted in clinical remission and correction of hypercortisolism and normal plasma ACTH levels. The histology was that of an atypical carcinoid. Bronchial carcinoid tumour is an extremely uncommon but well recognised cause of ectopic Cushing's syndrome. These patients may pose diagnostic dilemma in distinguishing form those with Cushing's disease because of the similarity in the clinical, biochemical and radiologic findings.
本文描述了一名17岁女性,其左胸有一巨大肿块,并伴有异位库欣综合征。生化评估显示为促肾上腺皮质激素(ACTH)依赖性高皮质醇状态。手术切除肿瘤后实现了临床缓解,高皮质醇血症得到纠正,血浆ACTH水平恢复正常。组织学检查结果为非典型类癌。支气管类癌瘤是异位库欣综合征极为罕见但已得到充分认识的病因。由于这些患者在临床、生化和影像学表现上存在相似性,因此在与库欣病患者进行鉴别诊断时可能会造成诊断困境。