CUSHING'S SYNDROME DUE TO ADRENAL CORTICAL CANCER

Suzuki Kazuo, Tajima Atsushi, Fujita Kimio, Aso Yoshio, Hiruma Satoshi, Motegi Yasuhira

doi:10.5980/jpnjurol1928.71.3_289

A 41-year-old male was admitted with complaints of back ache and easy fatigability. Blood pressure was 150/60. Central obesity and buffalo hump were observed. Urinary 17-OHCS and 17-KS were increased. Endocrinological and roentgenological studies suggested left adrenal cortical cancer. Left adrenalectomy with para-aortic lymph node dissection was performed on October 19, 1977. The tumor was removed together with left kidney. It measured 12.5×18.0×7.5cm and weighed 1, 190g. Postoperatively the patient improved temporarily. Metastases to lung and liver, however, developed and he died four months after the operation. Electron microscopic examination of the tumor revealed poorly developed smooth surfaced endoplasmic reticuli and decreased number of mitochondria with sparse short tubular cristae. This finding is different from that of cells in normal fascicular and reticular zones which have abundant smooth and rough surfaced reticuli and mitochondria with vesicular cristae. It was suggested that each tumor cell had less steroid producing ability compared with normal adrenocortical cell, although the whole tumor was producing a large amount of steroids. Slow production of steroids in the tumor might have delayed the diagnosis of the disease, while the tumor itself had already grown up to invade the adjoining organs. The authors assume that the activity to produce steroids in the tumor is not paralleled with its growing or invading activity.

CUSHING'S SYNDROME DUE TO ADRENAL CORTICAL CANCER

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