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[The ectopic ACTH syndrome].

Zorana Penezić1, Slavica Savić, Svetlana Vujović

  • 1Institut za endokrinologiju, dijabetes i bolesti metabolizma Klinicki centar Srbije Dr Subotića 13, 11000 Beograd. zpenezic@eunet.yu

Srpski Arhiv Za Celokupno Lekarstvo
|July 2, 2004
PubMed
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This case study highlights a pulmonary carcinoid tumor causing ectopic adrenocorticotropic hormone (ACTH) secretion, leading to Cushing's syndrome. Surgical resection resolved the condition, emphasizing the importance of thoracic imaging in diagnosing ACTH-dependent Cushing's syndrome.

Area of Science:

  • Endocrinology
  • Oncology
  • Pathology

Background:

  • Endogenous Cushing's syndrome results from prolonged excessive cortisol exposure, disrupting the hypothalamo-pituitary-adrenal axis.
  • Causes include pituitary adenomas, ectopic adrenocorticotropic hormone (ACTH) secretion, or adrenal tumors.

Observation:

  • A 31-year-old male presented with symptoms of hypercortisolism, including weight gain and proximal myopathy.
  • Diagnostic tests revealed hyperglycemia, hypokalemia, a blunted circadian cortisol rhythm, elevated ACTH, and unresponsiveness to dexamethasone suppression.
  • Imaging identified a pulmonary mass, later confirmed as a neuroendocrine tumor immunoreactive for ACTH.

Findings:

  • The patient was diagnosed with ectopic ACTH syndrome secondary to a pulmonary carcinoid tumor.

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  • Surgical resection of the tumor led to the resolution of Cushing's syndrome symptoms.

    • Implications:

    • This case underscores the significance of pulmonary carcinoid tumors as a cause of ectopic ACTH secretion and Cushing's syndrome.
    • Thoracic CT scanning is crucial for diagnosing ACTH-dependent Cushing's syndrome when pituitary imaging is negative.