後腹膜神経節細胞腫の1例

症例は, 卵巣腫瘍で当院婦人科へ入院の患者で, 術前排泄性腎孟撮影検査を受けた.この結果右腎がやや下降していたため, CT検査を行い副腎腫瘍が疑われた.しかし選択的に副腎動脈造影を施行したところ, 正常副腎が描出され, 副腎のhypovascular massか後腹膜腔腫瘍が疑われた.上記診断のもとに, 手術を行ない, 後腹膜腔発生の神経節細胞腫と診断した.後腹膜腔原発の神経節細胞腫としては, われわれの症例が本邦第37例目であると考えられる.We describe a rare case of a primary retroperitoneal ganglioneuroma that was found accidentally during preoperative examinations conducted due to a suspicion of ovarian cancer. Computerized tomography was not able to differentiate the retroperitoneal mass from an adrenal tumor. We diagnosed the retroperitoneal tumor by means of selective adrenal angiography

男性化副腎皮質癌の1例

A 36-year-old woman who had experienced two pregnancies consulted our hospital, because of scant menses and virilization. A 24-hour excretion of 17-ketosteroids and 17-hydroxy-corticosteroids demonstrated a decrease in 11-hydroxylase. A computed tomogram showed a huge inhomogenous tumefaction in the left adrenal. Left selective renal angiography revealed a large adrenal tumefaction. Selective adrenal venous samplings revealed that testosterone and dehydroepiandrosterone (DHA) were produced in response to stimulation by 0.25 mg exogenous adrenocorticotropic hormone (ACTH). After left adrenalectomy was performed, a diagnosis of adrenocortical carcinoma was made by pathological examination. This is the first report of a patient with a virilizing adrenocortical carcinoma, which produced testosterone and DHA in response to exogenous ACTH stimulation

男性化手術を施行した女子先天性副腎皮質過形成(21-hydroxylase欠損)の1例

21・hydroxylase欠損による先天性副腎皮質過形成をもつ25歳女子(戸籍上は男子)症例に対して2度にわたる男性化手術をおこなった.1度目は卵巣子宮附属器切除術と索切除術であり, 2度目は11ヵ月後の尿道形成術と両側偽睾丸挿入術である.術後の排尿機能と勃起の状態は良好であった.A 25-year-old female with simple virilizing type of congenital adrenocortical hyperplasia due to 21-hydroxylase deficiency was treated surgically with masculinizing operations which consisted of two-stage procedures. The first procedure was chordectomy associated with excision of both gonads and female internal genitalia. Eleven months later, the second procedure consisting of urethroplasty and implantation of testicular prosthesis was performed. The postoperative course was successful in terms of urination and penile erection