Diagnosis and management of small pulmonary atypical carcinoid tumor associated with Cushing syndrome

Ectopic adrenocorticotropic hormone ( ACTH) syndrome is rare and identification of its source is often challenging. We report the case of an ectopic Cushing syndrome in a young adult male secondary to an occult ACTH producing atypical carcinoid tumor. Extensive biochemical and imaging workup was unr...

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Bibliographic Details
Published inLung cancer management Vol. 9; no. 4; p. LMT41
Main Authors Benissan-Messan, Dathe Z, Merritt, Robert E, Shilo, Konstantin, D'Souza, Desmond M, Kneuertz, Peter J
Format Journal Article
LanguageEnglish
Published England Future Medicine Ltd 01.12.2020
Subjects
atypical carcinoid
Case Report
ectopic ACTH syndrome
ectopic Cushing syndrome
Ga-DOTA PET
hypercortisolemia
neuroendocrine tumors
pulmonary carcinoid
video-assisted thoracoscopic surgery
atypical carcinoid
hypercortisolemia
Ga-DOTA PET
pulmonary carcinoid
ectopic ACTH syndrome
ectopic Cushing syndrome
video-assisted thoracoscopic surgery
neuroendocrine tumors
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Summary:Ectopic adrenocorticotropic hormone ( ACTH) syndrome is rare and identification of its source is often challenging. We report the case of an ectopic Cushing syndrome in a young adult male secondary to an occult ACTH producing atypical carcinoid tumor. Extensive biochemical and imaging workup was unrevealing. The diagnosis was aided by Ga-DOTA PET scan demonstrating a suspicious left upper lobe lung nodule. The patient underwent video-assisted thoracoscopic exploration with wedge resection and mediastinal lymphadenectomy of a T2aN2M0 atypical carcinoid, resulting in the normalization of ACTH levels and complete resolution of symptoms. The role of a Ga-DOTA PET scan in diagnosing pulmonary carcinoid tumors and their management are discussed.
ISSN:1758-1966
1758-1974
DOI:10.2217/lmt-2020-0010