123. 一位49歲女性病人因為B型肝炎帶原追蹤腹部超音波發現有右側腎上腺腫瘤，腎上腺電腦斷層顯示腫瘤大小為4公分， CT density 為10 HU。她的檢驗結果如下：cortisol (8am) 16.0 ug/dL, cortisol (4pm) 12.2ug/dL, ACTH 13.7 pg/mL, aldosterone 18 ng/dL, plasma renin activity 0.95 ng/mL/hr, urine VMA 4.7mg/24hr, urine dopamine 254.5 ug/24 hr, urine epinephrine 9.3 ug/24hr, urine norepinephrine 83.5ug/24hr。請問以下哪一項敘述正確？(參考值； cortisol (8am) 5.0~25.0 ug/dL, cortisol (4pm) 2.5~12.5ug/dL, ACTH 7.4~57.3 pg/mL, plasma renin activity 1~5 ng/mL/hr, aldosterone 5~30 ng/dL, urinedopamine 50~450 ug/24 hr, urine epinephrine ＜ 22.4 ug/24hr, urine norepinephrine 12.1~85.5 ug/24hr,urine VMA 1~7 mg/24hr)
(A) 絕大多數單側腎上腺腫瘤為分泌cortisol的良性腫瘤
(B) 此病人應該優先考慮primary aldosteronism
(C) 使用利尿劑或三環抗憂鬱藥物可能引起urine catecholamine 假性偏低
(D) 應該加測17-hydroxyprogesterone 及DHEAS
(E) 建議手術切除此腎上腺腫瘤