内分泌非活性副腎皮質癌

NONFUNCTIONING ADRENAL CORTICAL CARCINOMA: REPORT OF A CASE

　症例は42歳男性で，左上腹部痛を主訴として来院した。内分泌学的検査で異常はなく，左副腎非活性腫瘍の診断にて手術を施行した。病理組織学的には副腎皮質癌であつた。退院11ヵ月後，肝転移が認められ，このとき施行した内分泌検査で尿中17—OHCSの値が術前の10倍を示していた。このため非機能性副腎癌から機能性副腎癌へ変化したと考えられた。

A 42-year-old man was admitted to our hospital with complaint of left upper abdominal pain. CT scan, adrenal scintigram and angiography showed left adrenal mass. But there were no abnormalties in the endocrinological examination. Under diagnosis of left nonfunctioning adrenal tumor, left adrenec-tomy was performed. Tumor was 10. 0 × 8. 5 × 7. 0 cm in size and 300 g in weight. Histological diagnosis was left adrenal cortical carcinoma without lymphnode metastasis. About 11 months after the operation, the patient complained fever and epigastric pain. CT scan showed liver metastasis and pleural effusion.