Ectopic ACTH Secretion Induced by an Olfactory Neuroblastoma: A Case Report

Area of Science:

• Oncology
• Endocrinology
• Otolaryngology

Background:

• Olfactory neuroblastoma (ONB) is a rare malignant tumor arising from the nasal cavity.
• ONB can secrete adrenocorticotropic hormone (ACTH), leading to Cushing's syndrome, complicating diagnosis.
• Cushing's syndrome presentation in ONB cases poses diagnostic challenges.

Observation:

• A 65-year-old male presented with hypokalemia and weakness, indicative of Cushing's syndrome.
• Brain imaging identified an ethmoid bone tumor with cysts, initially misdiagnosed.
• A second biopsy confirmed olfactory neuroblastoma, as initially suspected by an otolaryngologist.

Findings:

• The patient underwent neoadjuvant chemotherapy, surgery, and radiotherapy for the ONB.
• Successful treatment led to the resolution of Cushing's syndrome.
• The patient achieved a 10-year remission from the olfactory neuroblastoma.

Implications:

• Cushing's syndrome can be an unusual presenting sign of olfactory neuroblastoma.
• Accurate diagnosis of ONB necessitates thorough imaging analysis and interdisciplinary consultation with pathologists.
• Timely and accurate diagnosis improves patient outcomes for rare tumors like ONB.