同一副腎内にコルチゾール産生腺腫と褐色細胞腫を合併した一例

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  • A Case of a Combined Tumor Consisting of Adrenocortical Adenoma and Pheochromocytoma

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The suppression of anterior pituitary hormones with excessive glucocorticoids has been described by several investigators. To evaluate the effect of hypercortisolemia on the pituitary gland, we describe a 40-year-old woman with an adrenal adenoma causing Cushing's syndrome in whom pituitary function was estimated before and after successful removal of a left adrenal tumor.<BR>She was admitted because of fatigue. Physical examination and laboratory data suggested Cushing's syndrome. No change in serum ACTH, an impaired response of serum GH and serum TSH, and a paradoxical rise in prolactin were recorded after administrations of insulin, TRH, and LH-RH suggested that the anterior pituitary functions were abnormal. In 1993, left adrenal gland (measuring 4.0×2.5cm) was resected. The tumor consisted of two parts: a reddish red brown cortical adenoma (4.0×2.5 cm) and white pheochromocytoma (0.8×0.7 cm).<BR>One year after tumor excision, all pituitary hormonal responses to various stimuli had returned to normal. Thus, we report an extremely rare case of Cushing's syndrome (cortical adenoma) associated with pheochromocytoma showing as hypothyroidism.

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