Post-thymectomy collapse: an unusual case of acute adrenal insufficiency.
A 54-year-old man who had an appearance strongly suggestive of Cushing's syndrome, collapsed after the removal of a carcinoid tumour of the thymus. The clinical suspicion of acute adrenal insufficiency was supported by invasive haemodynamic data and the diagnosis was subsequently confirmed biochemically. These post-operative events were subsequently ignored and a further crisis was probably prevented by tumour recurrence (and hence resumption of adrenocorticotropic hormone (ACTH) production). The ectopic production of ACTH from a carcinoid tumour of the thymus is recognised but a report of acute adrenal insufficiency from its removal is probably unique.
Richardson
J
J
Department of Anaesthetics, Bradford Royal Infirmary, UK.
D000208:Acute Disease; D000309:Adrenal Insufficiency / Q000209:etiology*; D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D002276:Carcinoid Tumor / Q000601:surgery*; D003480:Cushing Syndrome / Q000209:etiology; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D013934:Thymectomy; D013953:Thymus Neoplasms / Q000601:surgery*
D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone