论文部分内容阅读
柯兴氏病患者大约有10%能被放射学发现垂体肿瘤。另有60%或更多是在尸检时才发现潜在微小腺瘤。另一组患者在双侧肾上腺切除术后数月或数年,促肾上腺皮质激素(ACTH)引起垂体肿瘤才明显起来。过去报告Nelson氏综合征为5%～16%,然而最近研究指出Nelson氏综合征的实际发病率可能是低估了。鉴于这些肿瘤伴有高度灶性侵袭性及眼的合并症而显得特别重要。因此作者复习了1951～1976年间25年来在作者医院诊断为柯兴氏病并经双侧肾上腺全切除治疗的全部38例病例。其中肾上腺腺瘤4例(11%),肾上腺皮质癌1例,柯兴氏病双侧肾上腺增生33例。后者2例(6%)示垂本窝增大,用单独放疗或放疗加肾上腺切除;2例蝶鞍断层摄影正常,经显微外科探查垂体发现垂体腺瘤;另7例并用放疗和肾上腺手术
About 10% of patients with Cushing’s disease can be found by radiology pituitary tumors. Another 60% or more were found at the time of autopsy of potential microadenomas. In another group of patients, several months or years after bilateral adrenalectomy, adrenocorticotropic hormone (ACTH) caused pituitary tumors to become apparent. In the past, Nelson’s syndrome was reported to be 5% to 16%. However, recent studies have shown that the actual incidence of Nelson’s syndrome may be underestimated. This is particularly important given that these tumors are associated with highly focal invasiveness and ocular complications. Therefore, the author reviewed all 38 cases of Cushing’s disease diagnosed in the author’s hospital during the period from 1951 to 1976 and treated with bilateral adrenalectomy. Among them, 4 cases (11%) of adrenal adenoma, 1 case of adrenal cortical carcinoma, and 33 cases of adrenal hyperplasia of Cushing’s disease. The latter 2 cases (6%) showed an increase in the penis, with radiotherapy alone or radiotherapy combined with adrenalectomy; 2 patients with normal sella radiography and pituitary adenoma detected by microsurgery; and 7 patients with radiotherapy and adrenal glands surgery