Cushing症候群を主徴とした副腎皮質癌の1剖検例

Abstract

A case of adrenocortical carcinoma seen in a 29-year-old woman was reported. She presented a typical Cushing's syndrome with moon face, obesity of Buffalo type, acne, hirsutism, amenorrhea and hypertension. Urinary 17KS was 225~486mg/day and 170HCS 24~60mg/day, both being elevated. Among the fractions of 17 KS, dehydroepiandrosterone and 11-hydroxyandrosterone were increased. Among those of 170HCS, an increase of tetrahydro-compound S was striking. Pregnanetriol and pregnanediol were also increased. The patient died on the 54th day after a diagnosis was made. On autopsy, the left adrenal showed tumor of 12×9.5×6.5 cm in size involving the left kidney. Tumor thrombosis was seen in the adrenal vein bilaterally. Multiple metastases to the liver, lungs, right adrenal, lumbar vertebrae and lymph nodes were observed.