Primary hepatic carcinoid tumor presenting as Cushing's syndrome

N. A. Shah, I. A. Urusova, A. D'Agnolo, Steven D Colquhoun, B. E. Rosenbloom, S. L. Vener, S. A. Geller, M. Younes, J. Lechago, A. P. Heaney

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Hepatic carcinoid tumors are very uncommon; most are clinically non-functional and very few present with the symptoms of carcinoid syndrome. ACTH-producing carcinoid tumors most commonly originate in the lung or thymus and present insidiously with bronchospasm and/or chest mass. Occasionally, ectopic ACTH syndromes have been reported in association with pancreatic islet cell tumors, medullary thyroid cancer, pheochromocytoma, small-cell lung carcinoma, and rarely, ovarian and prostate tumors. We report here a patient with an ectopic ACTH-secreting primary hepatic carcinoid tumor who presented with cushingoid appearance, profound proximal muscle weakness, severe lower extremity edema, and markedly elevated urinary free cortisol. ACTH levels were in the low normal range. A solitary vascular hepatic lesion was found on magnetic resonance imaging, which was isodense with the surrounding liver on octreotide scan and photopenic on an 18-fluorodeoxyglucose (18FDG)-positron emission tomography (PET) scan. Following surgical resection of the hepatic tumor, histopathology confirmed an ACTH-secreting neuroendocrine tumor (NET), the patient had complete resolution of hypercortisolemic symptoms and remains in remission, now 4 yr after hepatic tumor resection. This case reports the first ACTH-secreting primary hepatic NET presenting as ectopic Cushing's syndrome. Interesting aspects of this case include the presence of a pituitary incidentaloma, the low normal ACTH, and photopenia on 18FDG-PET imaging.

Original languageEnglish (US)
Pages (from-to)327-333
Number of pages7
JournalJournal of Endocrinological Investigation
Volume30
Issue number4
DOIs
StatePublished - Jan 1 2007
Externally publishedYes

Fingerprint

Cushing Syndrome
Carcinoid Tumor
Adrenocorticotropic Hormone
Liver
Neuroendocrine Tumors
Positron-Emission Tomography
Ectopic ACTH Syndrome
Neoplasms
Bronchial Spasm
Octreotide
Muscle Weakness
Small Cell Lung Carcinoma
Pheochromocytoma
Thymus Gland
Blood Vessels
Hydrocortisone
Prostate
Lower Extremity
Edema
Reference Values

Keywords

  • ACTH
  • Actopic
  • Cushing's
  • Hepatic carcinoid
  • Neuroendocrine tumor

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Shah, N. A., Urusova, I. A., D'Agnolo, A., Colquhoun, S. D., Rosenbloom, B. E., Vener, S. L., ... Heaney, A. P. (2007). Primary hepatic carcinoid tumor presenting as Cushing's syndrome. Journal of Endocrinological Investigation, 30(4), 327-333. https://doi.org/10.1007/BF03346308

Primary hepatic carcinoid tumor presenting as Cushing's syndrome. / Shah, N. A.; Urusova, I. A.; D'Agnolo, A.; Colquhoun, Steven D; Rosenbloom, B. E.; Vener, S. L.; Geller, S. A.; Younes, M.; Lechago, J.; Heaney, A. P.

In: Journal of Endocrinological Investigation, Vol. 30, No. 4, 01.01.2007, p. 327-333.

Research output: Contribution to journalArticle

Shah, NA, Urusova, IA, D'Agnolo, A, Colquhoun, SD, Rosenbloom, BE, Vener, SL, Geller, SA, Younes, M, Lechago, J & Heaney, AP 2007, 'Primary hepatic carcinoid tumor presenting as Cushing's syndrome', Journal of Endocrinological Investigation, vol. 30, no. 4, pp. 327-333. https://doi.org/10.1007/BF03346308
Shah, N. A. ; Urusova, I. A. ; D'Agnolo, A. ; Colquhoun, Steven D ; Rosenbloom, B. E. ; Vener, S. L. ; Geller, S. A. ; Younes, M. ; Lechago, J. ; Heaney, A. P. / Primary hepatic carcinoid tumor presenting as Cushing's syndrome. In: Journal of Endocrinological Investigation. 2007 ; Vol. 30, No. 4. pp. 327-333.
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