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Pancreatic insuloma causing Cushing's syndrome
1Département de Médicine Interne, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Journal of Endocrinological Investigation
|May 1, 1989
Summary
Accurate localization of ectopic ACTH-dependent Cushing
Area of Science:
- Endocrinology
- Oncology
- Medical Diagnostics
Background:
- Cushing's syndrome diagnosis relies on precise localization of hormone-secreting tumors.
- Ectopic ACTH-dependent Cushing's syndrome presents diagnostic challenges.
- Advanced imaging and biochemical tests are crucial for tumor localization.
Observation:
- A 45-year-old woman presented with ACTH-dependent Cushing's syndrome.
- Standard dexamethasone suppression and CRF stimulation tests were inconclusive.
- Petrosal venous sampling showed no gradient, suggesting a portal system-drained tumor.
Findings:
- Abdominal ultrasonography identified a pancreatic mass.
- Surgical excision revealed a benign islet cell tumor positive for ACTH.
- Post-surgery, ACTH and cortisol levels normalized, confirming the tumor as the source.
Implications:
- This case highlights the utility of integrated diagnostic approaches for ectopic ACTH syndrome.
- Successful tumor localization and resection led to complete patient recovery.
- Emphasizes the importance of considering pancreatic islet cell tumors in ectopic ACTH Cushing's syndrome.