BACKGROUND Pregnancy complicated with adrenocortical carcinoma (ACC) is a sporadic syndrome that is characterized by hypertension, uncontrolled hypokalemia, severe heart failure, premature delivery and other adverse effects. The clinical presentation of adrenocortical carcinoma is vague and nonspecific, it is challenging to identify complications of pregnancy with adrenocortical carcinoma. Here we present a case of adrenocortical carcinoma during pregnancy. We describe how to distinguish secondary hypertension from other conditions and the importance of timely detection and treatment of such patients. CASE PRESENTATION A 22-year-old woman 30 weeks pregnant was hospitalized with uncontrolled hypertension and hypokalemia. An ultrasound examination of the right adrenal gland revealed a large mass. She underwent transabdominal adrenalectomy, and histopathology from the sample removed revealed an adrenocortical carcinoma. Five days after surgery, the patient had a premature rupture of the fetal membranes and gave birth to a newborn girl via vaginal delivery at 32 weeks of gestation. The newborn was transferred to the neonatal pediatrics ward, and the woman started receiving chemotherapy. CONCLUSIONS Pregnancy with adrenocortical carcinoma is a rare condition. This case alerts the obstetricians that analysis of hypertension, hypokalemia, the plasma level and circadian rhythm of plasma cortisol provides a strategy to diagnose adrenocortical carcinoma during pregnancy.

中文翻译：

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妊娠肾上腺皮质癌的诊断和治疗：一例报告。

背景技术妊娠并发肾上腺皮质癌（ACC）是一种散发性综合征，其特征在于高血压，不受控制的低钾血症，严重的心力衰竭，早产和其他不良反应。肾上腺皮质癌的临床表现是模糊且非特异性的，鉴定具有肾上腺皮质癌的妊娠并发症是具有挑战性的。在这里，我们介绍一个怀孕期间肾上腺皮质癌的病例。我们描述了如何将继发性高血压与其他疾病区分开来，以及及时发现和治疗此类患者的重要性。病例介绍一名怀孕30周的22岁妇女因无法控制的高血压和低钾血症住院。右肾上腺的超声检查发现肿块很大。她接受了腹部肾上腺切除术，并且从样本中取出的组织病理学显示出肾上腺皮质癌。手术后五天，患者胎膜早破，在妊娠32周时通过阴道分娩生下了一名新生女婴。新生儿被转移到新生儿儿科病房，该妇女开始接受化疗。结论肾上腺皮质癌是一种罕见的疾病。该病例提醒产科医生，对高血压，低血钾，血浆皮质醇水平和血浆昼夜节律的分析为妊娠期间肾上腺皮质癌的诊断提供了策略。该患者胎膜早破，在妊娠32周时通过阴道分娩生下了一名新生女孩。新生儿被转移到新生儿儿科病房，该妇女开始接受化疗。结论肾上腺皮质癌是一种罕见的疾病。该病例提醒产科医生，对高血压，低血钾，血浆水平和血浆皮质醇的昼夜节律的分析提供了诊断妊娠期间肾上腺皮质癌的策略。该患者胎膜早破，在妊娠32周时通过阴道分娩生下了一名新生女婴。新生儿被转移到新生儿儿科病房，该妇女开始接受化疗。结论肾上腺皮质癌是一种罕见的疾病。该病例提醒产科医生，对高血压，低血钾，血浆水平和血浆皮质醇的昼夜节律的分析提供了诊断妊娠期间肾上腺皮质癌的策略。