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上皮上腺癌中的神经瘤综合征:意想不到的模仿者
Corina Nava Suarez1, Janna Prater1, Jane Mayrin1
1Endocrinology, Jefferson Einstein Philadelphia Hospital, Philadelphia, USA.
Cureus
|August 1, 2024
概括
上皮层癌 (ACC) 可以出现危及生命的血栓,如肺栓塞和深静脉血栓塞 (DVT),由于高皮质醇. 早期识别和管理这些血栓事件对于患者的治疗结果至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 血管外科 血管外科
背景情况:
- 上皮层癌 (ACC) 是一种罕见且具有高死亡率的侵袭性上腺癌.
- 功能性ACC经常分泌多余的激素,导致不同的临床表现,可以掩盖潜在的恶性瘤.
- 功能性ACC的常见特征是高皮质醇症,越来越多地被认为是发生血栓栓塞的危险因素.
研究的目的:
- 报告一例与急性肺栓塞和深静脉血栓形成的上皮上腺癌病例.
- 要突出在ACC中高皮质醇和高凝固性之间的关联.
- 强调ACC中血栓形成的临床意义和预后影响.
主要方法:
- 一个被诊断患有上下皮层癌的患者的病例介绍.
- 最初的治疗包括针对静脉血栓栓塞的抗凝药和血栓切除术.
- 上腺瘤的手术切除和涉及的邻近结构,包括马匹血栓切除术.
主要成果:
- 该患者出现了急性肺栓塞和复发性深静脉血栓,这是高皮质醇症的次要原因,以及左上腺质量.
- 图像检查显示,邻近结构的侵袭和左静脉血栓.
- 尽管进行了激进的手术和医疗管理,但该患者经历了反复出现的出血和血栓形成.
结论:
- 上皮癌中的深静脉血栓形成可能源于高皮质醇诱导的高凝血能力,直接静脉入侵或血管入侵.
- 在ACC下下静脉血栓与预后不佳有关.
- 临床医生必须认识到这种罕见的并发症,以便及时进行干预和预后评估.
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