- 期刊
Superior Mesenteric Artery Syndrome Preceded by Diabetes Insipidus in Advanced Lung Cancer with Pituitary Metastasis - A Case Report
晚期肺癌因腦下腺轉移引發的尿崩症，隨後發生上腸繫膜動脈症候群－病例報告
摘要
轉移癌並不常發生在腦下腺，發生在腦下腺的轉移癌在女性以原發性乳癌最常見，而在男性則是肺癌。由於直接的血流供應，典型的腦下腺轉移癌好發於後葉，常伴隨著尿崩症狀。上腸繫膜動脈症候群這個罕見疾病，是由於十二指腸的第三部分，其外部前方受到來自上腸繫膜動脈以及後方受到來自主動脈的壓迫所致。典型的上腸繫膜動脈症候群致病機轉來自於腸繫膜的脂肪層變薄，導致上腸繫膜動脈及主動脈的夾角變小；而造成這樣的主要原因包括不同疾病導致的快速體重減輕或接受脊柱側彎手術。在此我們報告一位40歲男性晚期肺癌病例，表現出多尿症狀數個月後發生飯後嘔吐症狀。經診斷為上腸繫膜動脈症候群，而此症候群是由於腦下腺轉移造成尿崩症，進而引發嚴重脫水所致。他接受了去氨加壓素治療與營養支持，恢復其體液狀態並增加腸繫膜容積後，他的尿崩症狀以及上腸繫膜動脈症候群，在兩周內有顯著改善
並列摘要
The pituitary gland is an uncommon site of metastasis from most primary cancers of the breast in women and the lung in men. Because of the direct blood supply, typical pituitary metastases develop in the posterior lobe of the pituitary and present with symptoms of diabetes insipidus (DI). Superior mesenteric artery (SMA) syndrome is a rare disorder resulting from external compression of the third portion of the duodenum by the SMA anteriorly and the aorta posteriorly. The aortomesenteric angle is narrowed typically because of loss of the mesenteric fat pad due to rapid body weight loss or scoliosis surgery. We report the case of a 40-year-old male with advanced lung cancer presenting with progressive polyuria for months followed by postprandial vomiting. SMA syndrome due to severe dehydration and weight loss resulting from pituitary metastasis with DI was diagnosed. He then received desmopressin and nutritional support. The symptoms of DI and SMA syndrome resolved well within 2 weeks after restoring the body fluid status and increasing the mesenteric mass.
延伸閱讀
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