ECTOPIC ACTH-PRODUCING THYMIC NEUROENDOCRINE TUMOR MASQUERADING AS PITUITARY CUSHING’S DISEASE

Authors

  • Vanusha Devaraja Pillai
  • Gayathri Devi Krishnan
  • Subashini Rajoo
  • Mohammad Badrulnizam Long Bidin

Keywords:

ectopic ACTH, carcinoid tumor, Cushing's syndrome, pituitary hyperplasia

Abstract

CASE
Ectopic adrenocorticotrophic hormone (ACTH) syndrome is a challenging diagnosis. It is responsible for 10-20% of Cushing’s syndrome. We describe a 23-year-old Malaysian male who presented with Cushingoid features and severe hypokalaemia. Based on biochemical and radiological findings, he was initially diagnosed with pituitary Cushing’s disease and underwent pituitary adenomectomy. However, plasma ACTH level and serum cortisol were persistently raised postoperatively. The histopathological examination of the pituitary lesion revealed pituitary hyperplasia with negative ACTH staining. Further evaluation disclosed a sizeable mediastinal mass proven to be a carcinoid tumor. He achieved hypocortisolism after excision of the mediastinal mass with improved clinical parameters. This case prompts us to have a high index of suspicion for ectopic ACTH syndrome in cases of florid Cushing’s with stark biochemical parameters such as severe hypokalaemia and metabolic alkalosis.

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Author Biographies

Vanusha Devaraja Pillai

Hospital Kuala Lumpur, Malaysia

Gayathri Devi Krishnan

Hospital Kuala Lumpur, Malaysia

Subashini Rajoo

Hospital Kuala Lumpur, Malaysia

Mohammad Badrulnizam Long Bidin

Hospital Kuala Lumpur, Malaysia

References

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Published

2023-11-09

How to Cite

Pillai, V. D. ., Krishnan, G. D., Rajoo, S. ., & Bidin , M. B. L. (2023). ECTOPIC ACTH-PRODUCING THYMIC NEUROENDOCRINE TUMOR MASQUERADING AS PITUITARY CUSHING’S DISEASE. Journal of the ASEAN Federation of Endocrine Societies, 38(S3), 89. Retrieved from https://asean-endocrinejournal.org/index.php/JAFES/article/view/3465

Issue

Section

Poster Presentation | Pituitary

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