A Case of Cushing Syndrome Secondary to Ectopic Adrenocorticotropic Hormone Producing Carcinoid of the Duodenum

Uecker, John M.; Janzow, Matthew T.
May 2005
American Surgeon;May2005, Vol. 71 Issue 5, p445
Academic Journal
Cushing syndrome caused by adrenocorticotropic hormone (ACTH) production from solid tumors can result in life-threatening hypercortisolemia. Ectopic ACTH production is most commonly associated with bronchial carcinoids and squamous cell carcinoma of the lung. We report a case of Cushing syndrome caused by ectopic ACTH production from a carcinoid of the duodenum. The patient presented to an outside hospital in hypertensive crisis and diabetic ketoacidosis. After stabilization, diagnostic studies including a serum cortisol level, and computed tomography (CT) scans of the head, chest, abdomen, and pelvis revealed hypercortisolemia and a large mass in the head of the pancreas. Pancreaticoduodenectomy was performed. Pathologic investigation revealed a 1-cm carcinoid of the duodenum with two large metastatic lymph nodes near the head of the pancreas. This is the first reported case in the English literature of Cushing syndrome caused by ectopic ACTH production from a carcinoid of the duodenum.


Related Articles

  • Expanding treatment options for Cushing disease.  // Biomedical Market Newsletter;11/21/2011, Vol. 21, p11 

    The article offers information on the treatment option for cushing disease. It notes that cushing disease is a hormone disorder caused by a tumor in the anterior pituitary gland that results in the secretion of excess amounts of adrenocorticotropic hormone (ACTH). It also discusses the...

  • Ectopic Cushing's syndrome: Experience from a tertiary care centre. Bhansali, A.; Walia, Rama; Rana, S. S.; Dutta, P.; Radotra, B. D.; Khandelwal, N.; Bhadada, S. K. // Indian Journal of Medical Research;Jan2009, Vol. 129 Issue 1, p33 

    Background & objectives: Ectopic secretion of adrenocorticotropic hormone (ACTH) is rare, contributing In 10 per cent cases of endogenous Cushing's syndrome. We describe our experience of about two decades of patients with ectopic Cushing's syndrome (ECS) seen at a tertiary care centre from...

  • Internal jugular vein: Peripheral vein adrenocorticotropic hormone ratio in patients with adrenocorticotropic hormone-dependent Cushing's syndrome: Ratio calculated from one adrenocorticotropic hormone sample each from right and left internal jugular vein during corticotrophin releasing hormone stimulation test. Chittawar, Sachin; Bhattacharya, Saptarshi; Sahoo, Jai Prakash; Prakash, Siva; Bhalla, Ashu Seith; Kandasamy, Devasenathipathy; Arora, Arundeep; Gupta, Nandita; Tandon, Nikhil; Goswami, Ravinder; Khadgawat, Rajesh; Jyotsna, Viveka P.; Karak, Ashish Kumar; Bal, Chandra Sekhar; Pandey, Ravindra Mohan; Kumar, Guresh; Ammini, Ariachery C. // Indian Journal of Endocrinology & Metabolism;Jan/Feb2013, Vol. 17 Issue 1, p128 

    Background: Demonstration of central: Peripheral adrenocorticotropic hormone (ACTH) gradient is important for diagnosis of Cushing's disease. Aim: The aim was to assess the utility of internal jugular vein (IJV): Peripheral vein ACTH ratio for diagnosis of Cushing's disease. Materials and...

  • Laparoscopic bilateral adrenalectomy: results for 30 consecutive cases. Takata, M. C.; Kebebew, E.; Clark, O. H.; Duh, Q.-Y. // Surgical Endoscopy;Jan2008, Vol. 22 Issue 1, p202 

    Most patients requiring bilateral adrenalectomy have adrenocorticotropin hormone (ACTH)-dependent Cushing’s syndrome. Some of these patients are severely debilitated from the chronic effects of cortisol overproduction. This study aimed to analyze the indications, safety, efficacy, and...

  • Glucocorticoid- and Androgen-Secreting Black Adrenocortical Adenomas: Unique Cause of Corticotropin-Independent Cushing Sydrome. Tanaka, Satoshi; Tanabe, Akiyo; Aiba, Motohiko; Hizuka, Naomi; Takano, Kazue; Zhang, Jun; Young, William // Endocrine Practice;May2011, Vol. 17 Issue 3, pe73 

    Objective: To describe the unique association of corticotropin-independent Cushing syndrome caused by cortisol- and androgen-secreting black adrenal cortical adenomas with myelolipomatous change.Methods: We report the clinical, laboratory, radiologic, and pathologic findings from 2 patients who...

  • A Novel Medical Treatment of Cushing's Due to Ectopic ACTH in a Patient With Neurofibromatosis Type 1. Bano, Gul; Mir, Farheen; Beharry, Nigel; Wilson, Philip; Hodgson, Shirley; Schey, Stephen // International Journal of Endocrinology & Metabolism;2013, Vol. 11 Issue 1, p52 

    A 64-year-old male presented with neurofibromatosis 1 and Cushing's syndrome. Clinically he was over weight, depressed with extensive skin bruising and hypertension. His 24 hours urinary metanephrines, urinary 5HIAA, gut peptides and chromgranin levels were normal. His renal function and renal...

  • Cushing's Syndrome due to Ectopic ACTH from Bronchial Carcinoid: A Case Report and Review. Kenchaiah, Manohara; Hyer, Steve // Case Reports in Endocrinology;2012, p1 

    Despite advances in analytic and imaging techniques, the syndrome of ectopic adrenocorticotrophic hormone (ACTH) secretion from a tumour resulting in Cushing's syndrome continues to pose difficult diagnostic and therapeutic challenges. Dynamic testing may be equivocal and radiology...

  • Cushing's syndrome: Its complexities and care. McGann, Marlene // RN;Aug75, Vol. 38 Issue 8, p40 

    Presents information on Cushing's syndrome, which is due to increased secretion of cortisol by the adrenal cortex. Signs and symptoms presented by a woman with Cushing's syndrome; Etiology of the disease; Body systems affected by the syndrome. INSET: Nursing care of a patient with adrenal...

  • 18F-FDG uptake in bilateral adrenal hyperplasia causing Cushing’s syndrome. Basu, Sandip; Nair, Narendra // European Journal of Nuclear Medicine & Molecular Imaging;Mar2005, Vol. 32 Issue 3, p384 

    This article focuses on 18F-FDG uptake in bilateral adrenal hyperplasia causing Cushing's syndrome. A 19-year-old male, with a prior history of Cushing's syndrome secondary to ectopic ACTH secretion by a thymic carcinoid, had recurrence of symptoms of Cushing's syndrome 2 years after surgery and...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics