Ectopic Cushing’s syndrome: ACTH-producing pulmonary carcinoid. A case report
Journal Title: Міжнародний ендокринологічний журнал - Year 2018, Vol 14, Issue 4
Abstract
The article describes a clinical case of ectopic Cushing’s syndrome in a man aged 39 years. Characteristic signs of hypercorticism (obesity, arterial hypertension, striae, thinning of the extremities, myasthenia, diabetes mellitus, hypokalemia) developed over a period of 1.5 years. However, the diagnosis of Cushing’s syndrome was established after hospitalization for arterial hypertension. Hormones: adrenocorticotropic hormone (ACTH) — 110 pg/ml (7–69), daily urinary cortisol excretion — 3,400 μg/24 h (28.5–213.7). Magnetic resonance imaging of the pituitary gland, multislice helical computed tomography (MHCT) of the abdominal cavity organs and [111In-DTPA-D-Phe1]-octreotide scintigraphy have not revealed a tumor. Only after the MHCT of the thoracic organs, carcinoid of the left lung was found. The patient was operated, and then during 2 months he almost recovered. Pathohistological conclusion: well-differentiated neuroendocrine tumor. Level of cell expression of cytoplasmic markers of neuroendocrine differentiation: synaptophysin (+), chromogranin A (+), CD56 (–), CD68 (–). The proliferation index Ki 67 was 1 %. Hormones: ACTH — 34 pg/ml, serum cortisol — 13.69 μg/dl (6.2–19).
Authors and Affiliations
M. L. Kyryliuk, M. K. Tedeieiva
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