Cushing's syndrome due to ectopic adrenocorticotropic hormone production secondary to hepatic carcinoid

Diagnosis, treatment, and improved quality of life

Susan G. Coe, Winston Tan, Thomas P. Fox

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

INTRODUCTION: We describe a previously healthy 40-year-old woman with Cushing's syndrome caused by adrenocorticotropic hormone (ACTH) secretion from metastatic carcinoid. CASE REPORT: Over a 2-year period, the patient had multiple hospitalizations for uncontrolled hypertension, hyperglycemia, and hypokalemia. She had transient flushing, rashes, and a rapid weight gain. In addition, she developed anasarca and had a nontraumatic hip fracture 1 month before presentation. Subsequently, a hypertensive crisis resulted in admission to the intensive care unit and fine-needle aspiration of a liver lesion. DISCUSSION: A diagnosis of metastatic carcinoid was established. She was transferred to our hospital for further evaluation and management. On arrival, she had the signs of Cushing's syndrome. Despite extensive evaluation, her primary carcinoid tumor was not localized. She was treated successfully with bilateral adrenalectomy and octreotide. CONCLUSION: This case illustrates how early recognition of the signs and symptoms of excess ACTH is important for prompt and appropriate treatment.

Original languageEnglish (US)
Pages (from-to)875-878
Number of pages4
JournalJournal of General Internal Medicine
Volume23
Issue number6
DOIs
StatePublished - Jun 2008

Fingerprint

Ectopic Hormones
Cushing Syndrome
Carcinoid Tumor
Adrenocorticotropic Hormone
Quality of Life
Liver
Octreotide
Hypokalemia
Adrenalectomy
Hip Fractures
Fine Needle Biopsy
Exanthema
Hyperglycemia
Signs and Symptoms
Weight Gain
Intensive Care Units
Edema
Hospitalization
Therapeutics
Hypertension

Keywords

  • Carcinoid
  • Corticotropin
  • Cushing's disease
  • Cushing's syndrome
  • Ectopic adrenocorticotropic hormone
  • Neuroendocrine tumor

ASJC Scopus subject areas

  • Internal Medicine

Cite this

@article{8981efc602d14a02b39674694b92f732,
title = "Cushing's syndrome due to ectopic adrenocorticotropic hormone production secondary to hepatic carcinoid: Diagnosis, treatment, and improved quality of life",
abstract = "INTRODUCTION: We describe a previously healthy 40-year-old woman with Cushing's syndrome caused by adrenocorticotropic hormone (ACTH) secretion from metastatic carcinoid. CASE REPORT: Over a 2-year period, the patient had multiple hospitalizations for uncontrolled hypertension, hyperglycemia, and hypokalemia. She had transient flushing, rashes, and a rapid weight gain. In addition, she developed anasarca and had a nontraumatic hip fracture 1 month before presentation. Subsequently, a hypertensive crisis resulted in admission to the intensive care unit and fine-needle aspiration of a liver lesion. DISCUSSION: A diagnosis of metastatic carcinoid was established. She was transferred to our hospital for further evaluation and management. On arrival, she had the signs of Cushing's syndrome. Despite extensive evaluation, her primary carcinoid tumor was not localized. She was treated successfully with bilateral adrenalectomy and octreotide. CONCLUSION: This case illustrates how early recognition of the signs and symptoms of excess ACTH is important for prompt and appropriate treatment.",
keywords = "Carcinoid, Corticotropin, Cushing's disease, Cushing's syndrome, Ectopic adrenocorticotropic hormone, Neuroendocrine tumor",
author = "Coe, {Susan G.} and Winston Tan and Fox, {Thomas P.}",
year = "2008",
month = "6",
doi = "10.1007/s11606-008-0587-z",
language = "English (US)",
volume = "23",
pages = "875--878",
journal = "Journal of General Internal Medicine",
issn = "0884-8734",
publisher = "Springer New York",
number = "6",

}

TY - JOUR

T1 - Cushing's syndrome due to ectopic adrenocorticotropic hormone production secondary to hepatic carcinoid

T2 - Diagnosis, treatment, and improved quality of life

AU - Coe, Susan G.

AU - Tan, Winston

AU - Fox, Thomas P.

PY - 2008/6

Y1 - 2008/6

N2 - INTRODUCTION: We describe a previously healthy 40-year-old woman with Cushing's syndrome caused by adrenocorticotropic hormone (ACTH) secretion from metastatic carcinoid. CASE REPORT: Over a 2-year period, the patient had multiple hospitalizations for uncontrolled hypertension, hyperglycemia, and hypokalemia. She had transient flushing, rashes, and a rapid weight gain. In addition, she developed anasarca and had a nontraumatic hip fracture 1 month before presentation. Subsequently, a hypertensive crisis resulted in admission to the intensive care unit and fine-needle aspiration of a liver lesion. DISCUSSION: A diagnosis of metastatic carcinoid was established. She was transferred to our hospital for further evaluation and management. On arrival, she had the signs of Cushing's syndrome. Despite extensive evaluation, her primary carcinoid tumor was not localized. She was treated successfully with bilateral adrenalectomy and octreotide. CONCLUSION: This case illustrates how early recognition of the signs and symptoms of excess ACTH is important for prompt and appropriate treatment.

AB - INTRODUCTION: We describe a previously healthy 40-year-old woman with Cushing's syndrome caused by adrenocorticotropic hormone (ACTH) secretion from metastatic carcinoid. CASE REPORT: Over a 2-year period, the patient had multiple hospitalizations for uncontrolled hypertension, hyperglycemia, and hypokalemia. She had transient flushing, rashes, and a rapid weight gain. In addition, she developed anasarca and had a nontraumatic hip fracture 1 month before presentation. Subsequently, a hypertensive crisis resulted in admission to the intensive care unit and fine-needle aspiration of a liver lesion. DISCUSSION: A diagnosis of metastatic carcinoid was established. She was transferred to our hospital for further evaluation and management. On arrival, she had the signs of Cushing's syndrome. Despite extensive evaluation, her primary carcinoid tumor was not localized. She was treated successfully with bilateral adrenalectomy and octreotide. CONCLUSION: This case illustrates how early recognition of the signs and symptoms of excess ACTH is important for prompt and appropriate treatment.

KW - Carcinoid

KW - Corticotropin

KW - Cushing's disease

KW - Cushing's syndrome

KW - Ectopic adrenocorticotropic hormone

KW - Neuroendocrine tumor

UR - http://www.scopus.com/inward/record.url?scp=43949114494&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=43949114494&partnerID=8YFLogxK

U2 - 10.1007/s11606-008-0587-z

DO - 10.1007/s11606-008-0587-z

M3 - Article

VL - 23

SP - 875

EP - 878

JO - Journal of General Internal Medicine

JF - Journal of General Internal Medicine

SN - 0884-8734

IS - 6

ER -