Difficulties in diagnosis and management of ectopic Cushing syndrome

J Thorac Oncol. 2008 Apr;3(4):444-6. doi: 10.1097/JTO.0b013e318169e316.

Abstract

A 18-year-old man presented to a local hospital with muscle weakness, facial edema, and a 6 kg weight gain over 2 months. After a complete work-up, he was diagnosed with pituitary Cushing syndrome and treated with a bilateral adrenalectomy for Cushing syndrome and pituitary radiotherapy for Nelson syndrome. Twenty-five years later, his ectopic source of adrenocorticotropic hormone was revealed as a pulmonary neuroendocrine tumor, and a pulmonary resection was performed. Subsequently, a biochemical and clinical remission including hyperpigmentation was achieved.

Publication types

  • Case Reports

MeSH terms

  • ACTH Syndrome, Ectopic / diagnosis*
  • ACTH Syndrome, Ectopic / radiotherapy
  • ACTH Syndrome, Ectopic / surgery
  • Adolescent
  • Adrenalectomy
  • Adrenocorticotropic Hormone / metabolism*
  • Cushing Syndrome / diagnosis*
  • Cushing Syndrome / radiotherapy
  • Cushing Syndrome / surgery
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / etiology
  • Lung Neoplasms / surgery
  • Male
  • Nelson Syndrome / diagnosis*
  • Nelson Syndrome / radiotherapy
  • Nelson Syndrome / surgery
  • Neuroendocrine Tumors / diagnosis*
  • Neuroendocrine Tumors / etiology
  • Neuroendocrine Tumors / surgery
  • Positron-Emission Tomography

Substances

  • Adrenocorticotropic Hormone