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Bronchial carcinoid associated with Cushing's syndrome
A Oliaro1, P L Filosso, C Casadio
1Department of Thoracic Surgery, University of Turin, Italy.
The Journal of Cardiovascular Surgery
|October 1, 1995
Summary
A rare bronchial carcinoid tumor caused Cushing's syndrome, complicating diagnosis with co-existing lung mycosis. Surgical resection ultimately resolved the hypercortisolism, highlighting the importance of somatostatin receptor imaging in diagnosing neuroendocrine lung tumors.
Area of Science:
- Endocrinology
- Pulmonology
- Oncology
Background:
- Bronchial carcinoid tumors are the primary cause of Cushing's syndrome via ectopic ACTH production.
- Accurate diagnosis can be challenging due to confounding conditions, such as pulmonary mycosis.
- Ectopic ACTH syndrome presents with hypercortisolism, necessitating a thorough etiological investigation.
Observation:
- A patient presented with symptoms suggestive of Cushing's syndrome, complicated by pulmonary mycosis.
- Initial medical treatments including octreotide, ketoconazole, and mitotane were ineffective.
- Diagnostic imaging, including somatostatin receptor scintigraphy and CT scan, identified a lung lesion.
Findings:
- Somatostatin receptor scintigraphy revealed abnormal uptake in the left lung.
- A CT scan confirmed a lesion in the lingula, indicative of a neuroendocrine tumor.
- Atypical lung resection successfully removed the tumor and resolved the hypercortisolism.
Implications:
- This case underscores the diagnostic difficulties in neuroendocrine lung tumors presenting with ectopic ACTH production.
- Somatostatin receptor scintigraphy is crucial for localizing these rare tumors.
- Surgical intervention remains a key treatment modality for curative intent in resectable cases.