endosergЭндокринная хирургияEndocrine Surgery2306-35132310-3965Типография «Печатных дел Мастер»10.14341/serg2013239-44endoserg-6380Research ArticleСтатьиArticlesАКТГ-продуцирующая опухоль слепой кишки. Клинический случайACTH-Secreting tumor of cecum. Case reportKuznetsovN S

doktor med. nauk, professor, zav. otdelom khirurgii FGBU ENTs

-MarovaE I

doktor med. nauk, professor, FGBU ENTs

-RemizovO V

doktor med. nauk, zav. otdelom luchevoy diagnostiki FGBU ENTs

-LatkinaN V

kand. med. nauk, khirurg khirurgicheskogo otdela FGBU ENTs

-Voskoboynikov-

kand. med. nauk, khirurg khirurgicheskogo otdela FGBU ENTs

-DobrevaE A

klinicheskiy aspirant FGBU ENTs

-KrylovV V

klinicheskiy ordinator FGBU ENTs

kvenc@mail.ruVoronkovaI A

klinicheskiy aspirant FGBU ENTs

-20131506201372№2 (2013)3944Copyright © Kuznetsov N.S., Marova E.I., Remizov O.V., Latkina N.V., Voskoboynikov -., Dobreva E.A., Krylov V.V., Voronkova I.A., 20132013Kuznetsov N.S., Marova E.I., Remizov O.V., Latkina N.V., Voskoboynikov -., Dobreva E.A., Krylov V.V., Voronkova I.A.Kuznetsov N.S., Marova E.I., Remizov O.V., Latkina N.V., Voskoboynikov -., Dobreva E.A., Krylov V.V., Voronkova I.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surg-endojournals.ru/jour/article/view/6380

В литературе описаны немногочисленные наблюдения АКТГ-продуцирующей опухоли слепой кишки. В ФГБУ ЭНЦ поступила пациентка 52 лет с характерной клинической картиной гиперкортицизма. В результате проведенного обследования диагностирован АКТГ-эктопический синдром, причиной которого являлась нейроэндокринная опухоль слепой кишки. В связи с редкостью встречающейся нозологии, считаем целесообразным поделиться собственным клиническим опытом.

Ectopic hormonesecreting of cecum are rare. We report the case of a 52yearold woman with a typical clin ical picture of Cushing disease. Diagnostic tests confirmed ACTH dependent Cushing’s syndrome, which is caused by neuroendocrine tumor of the cecum. Due to the rarity of the disease, we believe it appropriate to share our experience of this group of patients.

синдром КушингаАКТГэктопический синдромопухоль слепой кишкинейро эндокринная опухольCushing syndromeACTHsyndromeneuroendocrine tumortumor of the cecumReferencesGustafsson B.I., Kidd M., Chan A., Malfertheiner M.V., Mod lin I.M. Bronchopulmonary Neuroendocrine Tumors. Саncer. 2008; 113 (1): 5–21.Gustafsson B.I., Kidd M., Chan A., Malfertheiner M.V., Mod lin I.M. Bronchopulmonary Neuroendocrine Tumors. Саncer. 2008; 113 (1): 5–21.Kulke H.M., Mayer R.J. Carcinoid tumors. N. Engl. J. Med. 1999; 340: 858–868.Kulke H.M., Mayer R.J. Carcinoid tumors. N. Engl. J. Med. 1999; 340: 858–868.Modlin I.M., Sandor A. An analysis of 8305 cases of carcinoid tumors. Cancer. 1997; 79: 813–829.Modlin I.M., Sandor A. An analysis of 8305 cases of carcinoid tumors. Cancer. 1997; 79: 813–829.Wallace S., Ajani J.A., Charnsangavej C. et al. Carcinoid tumors: imaging procedures and interventional radiology. WldWallace S., Ajani J.A., Charnsangavej C. et al. Carcinoid tumors: imaging procedures and interventional radiology. WldJ. Surg. 1996; 20: 147–156.J. Surg. 1996; 20: 147–156.Modlin I.M., Lye K.D.A., Kidd M. A 5decade analysis of 13,715 carcinoid tumours. Cancer. 2003; 97: 934–959.Modlin I.M., Lye K.D.A., Kidd M. A 5decade analysis of 13,715 carcinoid tumours. Cancer. 2003; 97: 934–959.Kirshbom P.M., Kherani A.R., Onaitis M.W. et al. Carcinoids of unknown origin: comparative analysis with foregut, midgut, and hindgut carcinoids. Surgery. 1998; 124: 1063–1070.Kirshbom P.M., Kherani A.R., Onaitis M.W. et al. Carcinoids of unknown origin: comparative analysis with foregut, midgut, and hindgut carcinoids. Surgery. 1998; 124: 1063–1070.Yao J.C., Hassan M., Phan A. et al. One Hundred Years after "Carcinoid": Epidemiology of and Prognostic Factors for Neuroendocrine Tumors in 35,825 Cases in the United States. J. Clin. Oncol. 2008; 26: 3063–3072.Yao J.C., Hassan M., Phan A. et al. One Hundred Years after "Carcinoid": Epidemiology of and Prognostic Factors for Neuroendocrine Tumors in 35,825 Cases in the United States. J. Clin. Oncol. 2008; 26: 3063–3072.Ross R.J.M., Trainer P.J. Endocrine investigation: Cushing’s syndrome. Clin. Endocrinol. 1998; 49: 153–155.Ross R.J.M., Trainer P.J. Endocrine investigation: Cushing’s syndrome. Clin. Endocrinol. 1998; 49: 153–155.Jung S.N., Kim H.S., Yu C.S. et al. Clinicopathologic charac teristics of colorectal neuroendocrine tumor. Korean J. Gastroenterol. 2006; 48 (2): 97103.Jung S.N., Kim H.S., Yu C.S. et al. Clinicopathologic charac teristics of colorectal neuroendocrine tumor. Korean J. Gastroenterol. 2006; 48 (2): 97103.Trainer P.J., Grossman A. The diagnosis and differential diag nosis of Cushing’s syndrome. Clin. Endocrinol. 1991; 34: 317–330.Trainer P.J., Grossman A. The diagnosis and differential diag nosis of Cushing’s syndrome. Clin. Endocrinol. 1991; 34: 317–330.Perakakis N., Laubner K., Keck T. et al. Ectopic ACTHsyn drome due to a neuroendocrine tumour of the appendix. Exp. Clin. Endocrinol. Diabetes. 2011; 119: 525–529.Perakakis N., Laubner K., Keck T. et al. Ectopic ACTHsyn drome due to a neuroendocrine tumour of the appendix. Exp. Clin. Endocrinol. Diabetes. 2011; 119: 525–529.Dobnig H., Stepan V., Leb G. et al. Recovery from severe osteoporosis following cure from ectopic ACTH syndrome caused by an appendix carcinoid. J. Internal Med. 1996; 239: 365–369.Dobnig H., Stepan V., Leb G. et al. Recovery from severe osteoporosis following cure from ectopic ACTH syndrome caused by an appendix carcinoid. J. Internal Med. 1996; 239: 365–369.Davies C.J., Joplin J.F., Welbourn R.B. Surgical management of the ectopic ACTH syndrome. Ann. Surg. 1982; 196: 246–258.Davies C.J., Joplin J.F., Welbourn R.B. Surgical management of the ectopic ACTH syndrome. Ann. Surg. 1982; 196: 246–258.Воронкова И.А., Арапова С.Д., Кузнецов Н.С.и др. Высо кодифференцированная нейроэндокринная карцинома червеобразного отростка с клиническими признаками циклического АКТГэктопического синдрома (клиничес кий случай). Клиническая морфология новообразований щитовидных желез: сб. научных трудов III Конференции. М., 2010; 22–23Воронкова И.А., Арапова С.Д., Кузнецов Н.С.и др. Высо кодифференцированная нейроэндокринная карцинома червеобразного отростка с клиническими признаками циклического АКТГэктопического синдрома (клиничес кий случай). Клиническая морфология новообразований щитовидных желез: сб. научных трудов III Конференции. М., 2010; 22–23Sehgal R., Mchayleh W., Reider J.A. et al. Adenocarcinoma of colon presenting as cushing’s syndrome. J. Clin. Oncol. 2010; 8: e126–е127.Sehgal R., Mchayleh W., Reider J.A. et al. Adenocarcinoma of colon presenting as cushing’s syndrome. J. Clin. Oncol. 2010; 8: e126–е127.Oberg K., Astrup L., Eriksson B. et al. Guidelines for the Management of Gastroenteropancreatic Neuroendocrine Tumours (Including Bronchopulmonary and Thymic Neoplasms). Part II – Specific NE Tumour Types. Acta Oncologica. 2004; 43: 626–636.Oberg K., Astrup L., Eriksson B. et al. Guidelines for the Management of Gastroenteropancreatic Neuroendocrine Tumours (Including Bronchopulmonary and Thymic Neoplasms). Part II – Specific NE Tumour Types. Acta Oncologica. 2004; 43: 626–636.Valo I., Rohmer V., Guyetant S. et al. Cushing’s syndrome caused by a welldifferentiated ileal neuroendocrine carcino ma. Endocrine Pathology. 2000; 11: 359–364.Valo I., Rohmer V., Guyetant S. et al. Cushing’s syndrome caused by a welldifferentiated ileal neuroendocrine carcino ma. Endocrine Pathology. 2000; 11: 359–364.Vilar L., Naves L.A., Freitas Mda C. et al. Endogenous Cushing’s syndrome: clinical and laboratorial features in 73 cases. Arq. Bras. Endocrinol. Metab. 2007; 51: 566–574.Vilar L., Naves L.A., Freitas Mda C. et al. Endogenous Cushing’s syndrome: clinical and laboratorial features in 73 cases. Arq. Bras. Endocrinol. Metab. 2007; 51: 566–574.Lindsay J.R., Nieman L.K. Differential diagnosis and imaging in Cushing’s syndrome. Endocrinol. Metab. Clin. N. Am. 2005; 34: 403–421.Lindsay J.R., Nieman L.K. Differential diagnosis and imaging in Cushing’s syndrome. Endocrinol. Metab. Clin. N. Am. 2005; 34: 403–421.Ремизов О.В. Рентгеновская томография надпочечников у больных при гиперкортицизме. Нейроэндокринология. В кн. Болезнь Иценко–Кушинга, под ред. акад. Дедова И.И. и чл.корр. Мельниченко Г.А. М., 2011; 128–136.Ремизов О.В. Рентгеновская томография надпочечников у больных при гиперкортицизме. Нейроэндокринология. В кн. Болезнь Иценко–Кушинга, под ред. акад. Дедова И.И. и чл.корр. Мельниченко Г.А. М., 2011; 128–136.Mullen J.T., Savarese D.M. Carcinoid tumors of the appendix: A populationbased study. J. Surg. Oncol. 2011; 104: 41–44.Mullen J.T., Savarese D.M. Carcinoid tumors of the appendix: A populationbased study. J. Surg. Oncol. 2011; 104: 41–44.Capella C., Heitz P.U., Hofler H. et al. Revised classification of neuroendocrine tumors of the lung, pancreas and gut. Digestion. 1994; 55: 11–23.Capella C., Heitz P.U., Hofler H. et al. Revised classification of neuroendocrine tumors of the lung, pancreas and gut. Digestion. 1994; 55: 11–23.Horton K.M., Kamel I., Hofmann L., Fishman E.K. Carcinoid tumors of the small bowel: A multitechnique imaging approach. Am. J. Roentgenol. 2004; 182; 559–567.Horton K.M., Kamel I., Hofmann L., Fishman E.K. Carcinoid tumors of the small bowel: A multitechnique imaging approach. Am. J. Roentgenol. 2004; 182; 559–567.Manning P.J., Evans M.C., Reid I.R. Normal bone mineral densit following cure of Cushing's syndrome. Clin. Endocrinol. 1992; 36: 229–234.Manning P.J., Evans M.C., Reid I.R. Normal bone mineral densit following cure of Cushing's syndrome. Clin. Endocrinol. 1992; 36: 229–234.Beuschlein F., Hammer G.D. Ectopic proopiomelanocortin syndrome. Endocrinol. Metab. Clin. N. Am. 2002; 31: 191–234.Beuschlein F., Hammer G.D. Ectopic proopiomelanocortin syndrome. Endocrinol. Metab. Clin. N. Am. 2002; 31: 191–234.Tabarin A., Valli N., Chanson P. et al. Usefulness of somato statin receptor scintigraphy in patients with occult ectopic adrenocorticotropin syndrome. J. Clin. Endocrinol. Metab. 1999; 84: 1193–1202.Tabarin A., Valli N., Chanson P. et al. Usefulness of somato statin receptor scintigraphy in patients with occult ectopic adrenocorticotropin syndrome. J. Clin. Endocrinol. Metab. 1999; 84: 1193–1202.Boudreaux J.P., Klimstra D.S., Hassan M.M. et al. The NANETS consensus guideline for the diagnosis and management of neuroendocrine tumors: welldiff erentiated neuroendocrine tumors of the Jejunum, Ileum, Appendix, and Cecum. Pancreas. 2010; 39: 753–766.Boudreaux J.P., Klimstra D.S., Hassan M.M. et al. The NANETS consensus guideline for the diagnosis and management of neuroendocrine tumors: welldiff erentiated neuroendocrine tumors of the Jejunum, Ileum, Appendix, and Cecum. Pancreas. 2010; 39: 753–766.

The authors declare that there are no conflicts of interest present.