ctopic Cushing’s syndrome: ACTH-producing pulmonary carcinoid. A case report

• Main Authors: M.L. Kyryliuk, M.K. Tedeieiva
• Format: Article
• Language: English
• Published: Publishing House Zaslavsky 2018-05-01
• Series: Mìžnarodnij Endokrinologìčnij Žurnal
• Subjects: ectopic Cushing’s syndrome; pulmonary carcinoid
• Online Access: http://iej.zaslavsky.com.ua/article/view/140193

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).