下垂体腺腫摘出後に発見された副腎腺腫によるCushing症候群の1例

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  • A CASE OF CUSHING'S SYNDROME DETECTED AFTER EXTIRPATION OF NON-FUNCTIONAL PITUITARY ADENOMA

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Cushing's synrome commonly occurs due to pituitary adenoma, and sometimes due to adrenal tumor. We experienced a case of this syndrome occurring 3 years after an operation for a non-functional pituitary adenoma.<br> A 69-year-old female who underwent surgical treatment for a pituitary adenoma 3 years before was admitted to the hospital because of fatigue and hypertension. Physical and endocrinological examination suggested Cushing's syndrome. Abdominal ultrasonography and CT scan revealed a right adrenal tumor 20 mm in diameter. Adrenal scintigraphy under dexamethazone suppression revealed the tumor was functional. Laparoscopic enucleation of the adrenal tumor was successfully carried out. Pathological findings revealed it an adenoma of the adrenal gland. Three cases of adrenal tumor combined with a pituitary tumor had been reported, two cases were heterochronous and the remainder was synchronous. The relationship between the previous pituitary tumor and adrenal tumor is unclear, because pituitary lesion was non-functional chromophobic adenoma. Careful follow up is required for the patient who had an endocrine organ tumor because it can be duplicated metachronously like example well known syndrome Multiple endocrine Neoplasms.

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