Subject(s)
Adrenal Insufficiency/chemically induced , Betamethasone/analogs & derivatives , Glucocorticoids/adverse effects , Substance Withdrawal Syndrome/etiology , Administration, Topical , Aged , Betamethasone/administration & dosage , Betamethasone/adverse effects , Glucocorticoids/administration & dosage , Humans , MaleABSTRACT
ACTH dependent Cushing syndrome accounts for approximately 80% of all Cushing syndrome. Distinguishing the pituitary origin from ectopic one is still a diagnosis problem in some cases, especially in bronchial carcinoids, because approximately 50% show cortisol suppresion after dexametasone and may be small and, therefore, difficult to detect in chest radiography. We present a case of a patient with ACTH dependent Cushing syndrome of difficult localization with usual diagnosis tests.
Subject(s)
ACTH Syndrome, Ectopic/diagnosis , Bronchial Neoplasms/metabolism , Carcinoid Tumor/metabolism , Cushing Syndrome/etiology , Diagnostic Errors , Pituitary ACTH Hypersecretion/diagnosis , ACTH Syndrome, Ectopic/blood , ACTH Syndrome, Ectopic/complications , Adrenocorticotropic Hormone/analysis , Adult , Biomarkers, Tumor/analysis , Bronchial Neoplasms/chemistry , Bronchial Neoplasms/diagnosis , Bronchial Neoplasms/diagnostic imaging , Bronchial Neoplasms/surgery , Bronchoscopy , Carcinoid Tumor/chemistry , Carcinoid Tumor/diagnosis , Carcinoid Tumor/diagnostic imaging , Carcinoid Tumor/surgery , False Negative Reactions , Female , Humans , Hypophysectomy , Pneumonectomy , Radiography , Unnecessary ProceduresABSTRACT
El síndrome de Cushing dependiente de ACTH supone aproximadamente el 80% de todos los síndromes de Cushing. Diferenciar el origen hipofisario del ectópico sigue siendo un problema diagnóstico en determinados casos, especialmente en los carcinoides bronquiales, ya que, aproximadamente, un 50% pueden presentar supresión de las concentraciones de cortisol tras dexametasona y suelen ser de pequeño tamaño y, por lo tanto, difíciles de detectar en la radiografía de tórax. Presentamos el caso de una paciente con síndrome de Cushing dependiente de ACTH, de difícil localización con las pruebas diagnósticas habituales (AU)
ACTH dependent Cushing syndrome accounts for approximately 80% of all Cushing syndrome. Distinguishing the pituitary origin from ectopic one is still a diagnosis problem in some cases, especially in bronchial carcinoids, because approximately 50% show cortisol suppresion after dexametasone and may be small and, therefore, difficult to detect in chest radiography. We present a case of a patient with ACTH dependent Cushing syndrome of difficult localization with usual diagnosis tests (AU)
Subject(s)
Humans , Female , Adult , Cushing Syndrome/diagnosis , Adrenocorticotropic Hormone , ACTH Syndrome, Ectopic/diagnosis , Pituitary ACTH Hypersecretion/physiopathology , Weight Gain , Carcinoid Tumor/complications , Lung Neoplasms/complicationsABSTRACT
El feocromocitoma es un tumor derivado de las células cromafines de la médula adrenal. Cuando afecta a células situadas en la cadena simpática, se denomina paraganglioma. Pese a ser infrecuente, debe incluirse entre las posibles causas de hipertensión, arritmias cardíacas y crisis de ansiedad. Presentamos el caso de una mujer con un feocromocitoma vesical y una lesión hepatocelular con captación positiva en el estudio isotópico con MIBG (metayodobencilguanidina) que se ha interpretado como un falso positivo El mielolipoma adrenal es un tumor benigno, poco frecuente, compuesto por tejido adiposo maduro y elementos hematopoyéticos diversos. Su hallazgo suele ser incidental, aunque en ocasiones pueden alcanzar gran tamaño y causar dolor abdominal y otros síntomas clínicos. La ecografía y la tomografía computarizada son herramientas útiles en su diagnóstico. Los tumores pequeños (< 6 cm) y asintomáticos pueden tratarse de forma conservadora con vigilancia periódica y los > 6 cm o con síntomas pueden precisar tratamiento quirúrgico. Presentamos un caso de mielolipoma adrenal gigante y a continuación se realiza una revisión de la literatura (AU)
Pheochromocytoma is a tumor derived from the chromaffin cells of the adrenal medulla. When this type of tumor involves the sympathetic ganglia it is called paraganglioma. Although infrequent, paraganglioma should be considered in the evaluation of hypertension, arrhythmias, and panic disorder. We report the case of a woman with bladder pheochromocytoma and a hepatic lesion. MIBG scintigraphy showed non-physiological uptake, which was interpreted as a false positive result (AU)
Subject(s)
Humans , Female , Middle Aged , 3-Iodobenzylguanidine , Pheochromocytoma , False Positive Reactions , Spectrometry, Gamma , Adenoma, Liver Cell/diagnosis , Liver Neoplasms/diagnosisABSTRACT
Pheochromocytoma is a tumor derived from the chromaffin cells of the adrenal medulla. When this type of tumor involves the sympathetic ganglia it is called paraganglioma. Although infrequent, paraganglioma should be considered in the evaluation of hypertension, arrhythmias, and panic disorder. We report the case of a woman with bladder pheochromocytoma and a hepatic lesion. MIBG scintigraphy showed non-physiological uptake, which was interpreted as a false positive result.
ABSTRACT
La tiroiditis subaguda, descrita por primera vez por De Quervain en 1904, es la causa principal de dolor tiroideo. Las etiologías más probables son una infección viral o un proceso inflamatorio postinfeccioso. La clínica típica incluye dolor cervical anterior, bocio difuso y alteración de la función tiroidea que sigue un curso predecible en la mayoría de los casos. Presentamos el caso de una paciente de 63 años con una tiroiditis subaguda de inicio focal, con un nódulo tiroideo doloroso a la palpación y manifestaciones sistémicas concomitantes (AU)
Subacute thyroiditis, first described by De Quervain in 1904, is the main cause of thyroid pain. The most likely cause is viral infection or a postviral inflammatoryprocess. Typical clinical manifestations include neck pain, diffuse goiter and thyroid dysfunction with a predictable course in most patients. We present a 63-year-old woman with focal subacute thyroiditis that presented as a painful thyroid nodule with associated systemic symptoms (AU)