Severe Ectopic Adrenocorticotropic Hormone Syndrome Due to Pulmonary Carcinoid Tumor: A Case Report and Literature Review

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2024-01-01

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Abstract

Background/Objective: Pulmonary carcinoid tumors are a rare cause of Cushing's syndrome and usually present with an indolent course. Here, we present a case of rapid onset and severe Cushing's syndrome due to a typical pulmonary carcinoid tumor. Case Report: A 32-year-old woman developed diabetes, hypertension, and weight gain of 50 pounds over 3 months. Laboratory evaluation was significant for elevated cortisol and adrenocorticotropic hormone levels and levels were nonsuppressible on low and high-dose dexamethasone suppression tests. Chest computed tomography revealed a pulmonary nodule and biopsy showed a typical carcinoid tumor. She was treated with steroidogenesis inhibitors with a plan for surgical excision but developed worsening complications of hypercortisolemia. She eventually underwent cryoablation of the tumor, but unfortunately passed away just 6 months after her initial presentation. Discussion: Cushing's syndrome in typical pulmonary carcinoid tumors is rarely seen and usually presents with mild hypercortisolism similar to Cushing's disease. Severe hypercortisolemia from typical pulmonary carcinoid tumors can represent a more aggressive pathology or metastatic disease. Severe Cushing's syndrome is associated with significant morbidity and mortality and requires rapid tumor localization as surgical resection can be curative. Conclusion: This case highlights a rare presentation of severe Cushing's syndrome due to a typical pulmonary carcinoid.

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Published Version (Please cite this version)

10.1016/j.aace.2024.08.002

Publication Info

Aldrete, Karissa, and Leena Shahla (2024). Severe Ectopic Adrenocorticotropic Hormone Syndrome Due to Pulmonary Carcinoid Tumor: A Case Report and Literature Review. AACE Clinical Case Reports. 10.1016/j.aace.2024.08.002 Retrieved from https://hdl.handle.net/10161/31627.

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Scholars@Duke

Shahla

Leena Shahla

Associate Professor of Medicine

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