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分泌ACTH的垂体癌肿极其罕见,现常用的术语为侵入性或转移性肿瘤,垂体癌肿的细胞类型不同于垂体腺瘤.除了肿瘤的转移和侵入以外,皮肤的色素沉着是这些病人突出的临床表现之一。高度色素沉着有时可以在肾上腺切除前观察到,测定ACTH提供了垂体癌肿的色素沉着的激素基础,且须在肾上腺没有切除之前获得。作者对一例由于侵入性垂体肿瘤伴恶性组织学特征的临床和生化改变而引起库兴氏综合征的病例进行了描述,并与异位ACTH综合征之间诊断进行了比较。
Pituitary tumors secreting ACTH are extremely rare. The commonly used terms are invasive or metastatic tumors. The cell type of pituitary cancer is different from that of pituitary adenomas. In addition to tumor metastasis and invasion, skin pigmentation is prominent in these patients. One of the clinical manifestations. High hyperpigmentation can sometimes be observed before adrenalectomy. Determination of ACTH provides the hormonal basis of pigmentation in pituitary cancer and must be obtained before the adrenal gland has been removed. The authors describe a case of Cushing’s syndrome due to clinical and biochemical changes in invasive pituitary tumors with malignant histological features and compare the diagnosis with ectopic ACTH syndrome.