性早熟を来した副腎皮質腺腫

PRECOClOUS PUBERTY DUE TO ADRENAL CORTICAL ADENOMA:A CASE REPORT

　患者は7歳の男児。6歳頃から陰毛の発育を認め，陰茎も増大してきたため受診。全身肥満と痪瘡あり。血中テストステロン，17-KS,17-OHCS,dehydroepiandrosterone-sulfate（DHEA-S）が著明高値。尿中高値でデキサメタゾン負荷でも抑制されず。CT，超音波にて左腎上方に境界明瞭な径3cmの腫瘤あり。副腎シンチグラムは左側に取り込み増強を認めた。左男性化副腎腫瘍による性早熟症と診断し，左副腎摘除術を施行。摘出標本は32×23×30mm,16gで被膜化されており，病理組織診断は副腎皮質腺腫であった。

The patient was a 7-year-old boy with a year history of developing pubic hair and increasing penile size. Sys-temic obesity and facial acnes were also observed. Serum testosterone and dehydroepiandrosterone-sulfate levels were markedly elevated. Urine 17-KS and 17- OHCS levels were elevated with no response to dex-amethasone. The abdominal CT revealed a left adrenal mass. A well-encapsulated tumor, 16 g in weight and 32x23x30mm in size was surgically removed. Patho-logical diagnosis was adrenal cortical adenoma.