期刊
ENDOCRINE JOURNAL
卷 57, 期 8, 页码 679-686出版社
JAPAN ENDOCRINE SOC
DOI: 10.1507/endocrj.K10E-129
关键词
Ectopic ACTH syndrome; Somatostatin receptor scintigraphy; Bronchial carcinoid tumor; Octreotide; Neuroendocrine tumor
资金
- Ministry of Education, Science, Sports and Culture
- Ministry of Health, Welfare and Labor of Japan
A 75-year-old woman was admitted to our hospital because of a poor glycemic control She was found to have Cushingoid feature and dynamic endocrine tests showed elevated plasma ACTII and cortisol levels, lack of their circadian rhythm, non-suppressibility to high-dose dexamethasone, responsiveness to CRH, but not to DDAVP, and suppression to octreotide Pituitary MRI showed an equivocal small lesion CT scan of the chest showed two nodular lesions in the right lung (S5, S7), while a mild uptake was noted only in S5 lesion by FDG-PET, but positive uptake was only in S7 lesion by somatostatin receptor scintigraphy (SRS) Inferior petrosal sinus sampling revealed a gradient of plasma ACTH after CRH stimulation, consistent with the diagnosis of Cushing's disease She underwent middle and inferior lobectomy of the right lung The resected tumor in S7 was consistent with the diagnosis of a bronchial carcinoid tumor with positive ACTH immunoreactivity, while that of S5 was cryptococcal granuloma RT-PCR revealed abundant expressions of POMC and SSTR (-1, -2, -5). but not of CRHR and VlbR Postoperatively, abnormal endocrine data were normalized along with improvement of hypertension and diabetes This was a diagnostic challenging case with ectopic ACTH syndrome indistinguishable from Cushing's disease by various endocrine and imaging tests, among which SRS successfully localized the tumor responsible for ectopic ACTH secretion
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据