胸腺瘤致异位促肾上腺皮质激素综合征1例

库欣综合征是临床上较为常见的一类因糖皮质激素过多所产生的临床症候群，按其病因可分为促肾上腺皮质激素依赖型和非依赖型。现报告1例库欣综合征的女性患者，临床表现为轻度满月脸、雄激素增多的男性化特征、肤色加深、血压升高以及合并肺部感染等，病因未明。在影像学检查排除垂体肿瘤和肾上腺肿瘤之后，经胸部增强CT检查，发现病变部位在胸腺。予胸腔镜手术切除肿瘤，术后患者伤口感染，予多种抗生素行抗感染治疗，伤口愈合。随访21个月，患者的上述症状完全消失，近期预后良好。术后病理诊断为胸腺神经内分泌癌。此病例为1例典型的胸腺瘤异位分泌促肾上腺皮质激素，而导致库欣综合征，称为异位促肾上腺皮质激素综合征。

A case of ectopic adrenocorticotropic hormone syndrome caused by thymoma

Cushing’s syndrome is a clinically common type of clinical syndrome caused by excessiveglucocorticoids. It can be divided into adrenocorticotropic-dependent and independent typesaccording to its etiology. A female patient with Cushing’s syndrome is reported to have aclinical manifestation of mild full moon face, masculinization of androgen increase, deeper skincolor, elevated blood pressure, and pulmonary infection. The cause is unknown. Radiographicexamination indicated that pituitary tumor and adrenal tumors did not exist. Chest enhancementCT examination revealed that the lesion was in the thymus. Th oracoscopy was performed to removethe tumor. Since wound infection occurred aft er operation, a variety of antibiotics were used foranti-infective treatment, and the wound gradually healed. Aft er 21 months of follow-up, the abovesymptoms disappeared completely and the prognosis was good in the near future. Postoperativepathological diagnosis was thymic neuroendocrine carcinoma. This is a typical case that thethymoma ectopically secrets adrenocorticotropic hormone, which leads to Cushing’s syndrome,referring to ectopic adrenocorticotropic hormone syndrome.