摘要
Abstract
Objective To investigate clinical characteristics and diagnostic methods of adrenocortical carcinoma (ACC) in order to avoid misdiagnosis and mistreatment.Methods Clinical data of a misdiagnosed patient with ACC was retrospectively analyzed, and related literature was reviewed.Results The 28-year-old female was admitted for weight gain and amenorrhea for 1 year, edema in both lower extremities and weakness for three months.In the local hospital the patient was diagnosed as having diabetes, hypertension and invalid treatment, and was transferred to our endocrinology department, and the primary diagnosis was hypercortisolism and space occupying lesions in liver.After admission, examinations showed that blood cortisol levels were significantly increased, aldosterone levels were slightly increased and sex hormone levels were abnormal.Thoracic and abdominal CT showed retroperitoneal (right adrenal gland) massive space occupying lesions and metastasis in liver, tumor thrombus formation in right branch of portal vein and inferior vena cava, multiple metastatic nodules of double lungs and multiple rib fractures.The definitive diagnosis was right adrenal cortical carcinoma associated by extensive metastasis of the whole body, secondary diabetes and hypertension.Because of the huge tumor, metastasis of the whole body, surgical treatment was impossible.After controlling blood sugar and blood pressure, the patient discharged from hospital by herself with losing follow-up.Conclusion ACC is rare, and it is easy to metastasize with diverse manifestations in clinic.Mastering clinical features, analyzing the condition comprehensively, and performing the relevant endocrine hormone test and imaging examination in time are helpful to avoid misdiagnosis.关键词
肾上腺皮质肿瘤/误诊/皮质醇增多症Key words
Adrenal cortex neoplasms/Misdiagnosis/Hypercortisolism分类
医药卫生
