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Updated: Jun 21, 2026
06:08
A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
[ACTH-dependent Cushing syndrome, a diagnostic challenge].
Sergio Fuentes Tudanca1, Purificación Martínez de Icaya Ortiz de Urbina, Luis Muñoz De Dios
1Sección de Endocrinología. Hospital Severo Ochoa. Leganés. Madrid. España. drsfuentes@gmail.com
Summary
ACTH-dependent Cushing syndrome is common, but locating the source can be challenging. This case highlights difficulties in diagnosing ectopic ACTH production, even with standard tests.
Area of Science:
- Endocrinology
- Oncology
- Medical Diagnostics
Background:
- ACTH-dependent Cushing syndrome comprises 80% of Cushing syndrome cases.
- Differentiating pituitary from ectopic sources poses diagnostic challenges.
Observation:
- Bronchial carcinoids can present as ectopic ACTH sources.
- These tumors may exhibit partial cortisol suppression post-dexamethasone.
- Small tumor size complicates detection via chest radiography.
Findings:
- The presented case involves a patient with ACTH-dependent Cushing syndrome requiring difficult localization.
- Standard diagnostic tests proved insufficient for pinpointing the tumor's origin.
Implications:
- Highlights the need for improved diagnostic strategies for ectopic ACTH syndrome.
- Emphasizes the diagnostic challenges posed by bronchial carcinoids in Cushing syndrome.
- Suggests potential limitations of current imaging and suppression tests.
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