Related Experiment Video
Updated: Apr 30, 2026
06:08
A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
26.6K
Occult ectopic adrenocorticotropic hormone secretion: diagnostic dilemma and infective consequence
Njideka Momah1, Thomas Koroscil1
1Wright State University, Dayton, OH, USA.
Clinics and Practice
|April 26, 2014
Summary
Ectopic adrenocorticotropic hormone (ACTH) secretion from a thymic neuroendocrine tumor caused Cushing's syndrome. Despite surgery and treatment, the patient succumbed to opportunistic infections, highlighting diagnostic challenges.
Area of Science:
- Endocrinology
- Oncology
- Infectious Diseases
Background:
- Ectopic adrenocorticotropic hormone (ACTH) secretion can cause Cushing's syndrome.
- Thymic neuroendocrine tumors are rare causes of ectopic ACTH production.
- Diagnosing occult ACTH-secreting tumors presents significant clinical challenges.
Observation:
- A 42-year-old male presented with symptoms of excess cortisol, including polyuria, polydipsia, and weight loss.
- Diagnostic workup revealed ectopic ACTH secretion, with imaging identifying an anterior mediastinal lesion.
- Fine needle aspiration confirmed a thymic neuroendocrine tumor.
Findings:
- Despite radical thymectomy, plasma ACTH and cortisol levels remained elevated, indicating persistent or unresectable disease.
- The patient developed disseminated intracranial aspergillosis, a fatal opportunistic infection.
- The case highlights the difficulty in diagnosing and managing ectopic ACTH-secreting thymic tumors.
Implications:
- Occult ectopic ACTH-secreting tumors pose a diagnostic dilemma requiring high clinical suspicion.
- Aggressive management and prompt treatment of opportunistic infections are crucial for patient survival.
- This case emphasizes the importance of considering rare endocrine and oncologic conditions in complex presentations.
Related Concept Videos
01:19Cushing Syndrome II: Pathophysiology
24
Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features...
24
01:26Cushing Syndrome I: Introduction
36
Cushing syndrome refers to the collection of clinical manifestations that arise when tissues are exposed to excessive amounts of cortisol or cortisol-like medications over an extended period. Cortisol, a glucocorticoid produced by the adrenal cortex, regulates metabolism, immune responses, and the body’s adaptation to stress. When its concentration remains chronically elevated, these physiological pathways become dysregulated, resulting in the characteristic features of the...
36
01:27Adrenal Gland Disorders
3.7K
Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
3.7K
01:31Hormones of the Adrenal Glands
5.9K
Adrenal hormones play a pivotal role in maintaining the body's electrolyte balance and orchestrating responses to stress, showcasing the intricate functions of the adrenal cortex and medulla.
The adrenal cortex, a powerhouse of hormone synthesis, generates over two dozen corticosteroid hormones. The zona glomerulosa produces mineralocorticoids, exemplified by aldosterone, influencing the electrolyte composition of body fluids. The synthesis of glucocorticoids such as cortisol and...
The adrenal cortex, a powerhouse of hormone synthesis, generates over two dozen corticosteroid hormones. The zona glomerulosa produces mineralocorticoids, exemplified by aldosterone, influencing the electrolyte composition of body fluids. The synthesis of glucocorticoids such as cortisol and...
5.9K
01:17Anatomy of the Adrenal Glands
5.7K
The adrenal or supra-renal glands, situated above the kidneys and aligned with the twelfth rib, are paired pyramid-shaped structures crucial for the body's stress response. During stress, these glands secrete hormones vital for adaptive physiological reactions.
These glands possess a distinctive yellow tinge due to the stored cholesterol and fatty acids required for hormone synthesis. They are encased in a fibrous capsule and cushioned by fat.
The adrenal gland comprises two distinct...
These glands possess a distinctive yellow tinge due to the stored cholesterol and fatty acids required for hormone synthesis. They are encased in a fibrous capsule and cushioned by fat.
The adrenal gland comprises two distinct...
5.7K
01:19Regulation of Hormone Secretion
6.5K
Regulation of hormone secretion is a finely tuned orchestration driven by various types of stimuli, encompassing neural, humoral, and hormonal signals. Environmental cues instigate neural stimuli, where action potentials traverse nerve fibers to reach their designated targets. An illustrative scenario is the body's response to stress, wherein the sympathetic nervous system releases epinephrine from the adrenal glands, inducing the well-known 'fight or flight' reaction.
Humoral...
Humoral...
6.5K