Carney complex syndromeと診断した高齢者の下垂体腺腫の1例

A Case of a Pituitary Adenoma Diagnosed as Carney Complex Syndrome in an Older Female Patient

Ⅰ．はじめに

　Carney complex syndromeは1985年にCarney JAらによって報告された常染色体優性遺伝で全身性色素沈着，多臓器内分泌疾患を伴う家族性腫瘍性疾患である．今回われわれは，Carney complex syndromeと診断した高齢女性の下垂体腺腫の1症例を経験したので，文献的考察を踏まえて報告する．

　Carney complex syndrome is an autosomal dominant familial tumor syndrome first described by Carney et al. in 1985. The diagnostic criteria include endocrine hyperactivity and spotty skin pigmentation. A 73-year-old woman with cerebral infarction was referred to our department because her brain magnetic resonance imaging（MRI）revealed a pituitary tumor. Her blood tests revealed elevated levels of growth hormone（GH), thyroid stimulating hormone（TSH), and insulin-like growth factor-1（IGF-1). We suspected the presence of a GH-secreting tumor and performed the operation. The pathological finding was a TSH-positive pituitary adenoma. Her cervical computed tomography（CT）revealed a thyroid tumor and the tumor removal was performed. The pathological diagnosis was papillary carcinoma. She had skin pigmentation bilaterally on her face, forearms, hands, and legs. We diagnosed this case as Carney complex syndrome based on these findings.