Abstract
Ectopic ACTH-secreting pulmonary neuroendocrine tumors are rare and account for less than 5% of endogenous Cushing’s syndrome cases. We describe an unusual case of metastatic bronchial carcinoid tumor in a young woman presenting with unprovoked pulmonary emboli, which initially prevented the detection of the primary tumor on imaging. The source of ectopic ACTH was ultimately localized by a Gallium-DOTATATE scan, which demonstrated increased tracer uptake in a right middle lobe lung nodule and multiple liver nodules. The histological diagnosis was established based on a core biopsy of a hepatic lesion and the patient was started on a glucocorticoid receptor antagonist and a somatostatin analog. This case illustrates that hypercogulability can further aggravate the diagnostic challenges in ectopic ACTH syndrome. We discuss the literature on the current diagnosis and management strategies for ectopic ACTH syndrome.
| Original language | English (US) |
|---|---|
| Article number | 19-0033 |
| Journal | Endocrinology, Diabetes and Metabolism Case Reports |
| Volume | 2019 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2019 |
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ASJC Scopus subject areas
- Internal Medicine
- Endocrinology, Diabetes and Metabolism
Cite this
Pulmonary embolism as the presenting symptom and a confounder in ACTH-secreting bronchial carcinoid. / Yang, Wei; Pham, David; Vierra, Aren T.; Azam, Sarah; Gui, Dorina; Yoon, John C.
In: Endocrinology, Diabetes and Metabolism Case Reports, Vol. 2019, No. 1, 19-0033, 01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Pulmonary embolism as the presenting symptom and a confounder in ACTH-secreting bronchial carcinoid
AU - Yang, Wei
AU - Pham, David
AU - Vierra, Aren T.
AU - Azam, Sarah
AU - Gui, Dorina
AU - Yoon, John C.
PY - 2019/1
Y1 - 2019/1
N2 - Ectopic ACTH-secreting pulmonary neuroendocrine tumors are rare and account for less than 5% of endogenous Cushing’s syndrome cases. We describe an unusual case of metastatic bronchial carcinoid tumor in a young woman presenting with unprovoked pulmonary emboli, which initially prevented the detection of the primary tumor on imaging. The source of ectopic ACTH was ultimately localized by a Gallium-DOTATATE scan, which demonstrated increased tracer uptake in a right middle lobe lung nodule and multiple liver nodules. The histological diagnosis was established based on a core biopsy of a hepatic lesion and the patient was started on a glucocorticoid receptor antagonist and a somatostatin analog. This case illustrates that hypercogulability can further aggravate the diagnostic challenges in ectopic ACTH syndrome. We discuss the literature on the current diagnosis and management strategies for ectopic ACTH syndrome.
AB - Ectopic ACTH-secreting pulmonary neuroendocrine tumors are rare and account for less than 5% of endogenous Cushing’s syndrome cases. We describe an unusual case of metastatic bronchial carcinoid tumor in a young woman presenting with unprovoked pulmonary emboli, which initially prevented the detection of the primary tumor on imaging. The source of ectopic ACTH was ultimately localized by a Gallium-DOTATATE scan, which demonstrated increased tracer uptake in a right middle lobe lung nodule and multiple liver nodules. The histological diagnosis was established based on a core biopsy of a hepatic lesion and the patient was started on a glucocorticoid receptor antagonist and a somatostatin analog. This case illustrates that hypercogulability can further aggravate the diagnostic challenges in ectopic ACTH syndrome. We discuss the literature on the current diagnosis and management strategies for ectopic ACTH syndrome.
UR - http://www.scopus.com/inward/record.url?scp=85076210813&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85076210813&partnerID=8YFLogxK
U2 - 10.1530/EDM-19-0033
DO - 10.1530/EDM-19-0033
M3 - Article
AN - SCOPUS:85076210813
VL - 2019
JO - Endocrinology, Diabetes and Metabolism Case Reports
JF - Endocrinology, Diabetes and Metabolism Case Reports
SN - 2052-0573
IS - 1
M1 - 19-0033
ER -