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 W.
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
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U2 - 10.1007/s11606-008-0587-z
DO - 10.1007/s11606-008-0587-z
M3 - Article
C2 - 18386102
AN - SCOPUS:43949114494
SN - 0884-8734
VL - 23
SP - 875
EP - 878
JO - Journal of general internal medicine
JF - Journal of general internal medicine
IS - 6
ER -