| Ectopic Cushing's syndrome caused by a well differentiated ACTH-secreting neuroendocrine carcinoma of the ileum. | |
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MedLine Citation:
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PMID: 20162505 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Cushing's syndrome can be caused by adrenocorticotropic hormone-secreting solid tumors. We report a rare case of an ileal endocrine carcinoma that produced ACTH and induced hypercortisolism. A now 47-year-old man presented at age 41 with weight gain, tremor, perspiration, and general fatigue. Laboratory testing showed hypercortisolism and diabetes mellitus. Further examinations revealed ectopic Cushing's syndrome. The search for the primary tumor was difficult. The patient underwent subtotal thyroidectomy and surgical removal of a pituitary lesion. After resection of an ACTH-producing metastasis of the mesentery, temporary remission of Cushing's syndrome ensued. At the age 45 the primary tumor was detected in the ileum by Ga-68 DOTATOC-PET scan and explorative laparotomy. After surgical removal of this well differentiated neuroendocrine carcinoma the patient significantly improved clinically. He experienced better blood pressure and remission of his diabetes mellitus in addition to increased muscular strength. Endocrine laboratory testing at follow-up examinations confirmed remission of hypercortisolism and diabetes mellitus. A Ga-68 DOTATOC PET scan and a 1 mg dexamethasone suppression test 5 months after surgery showed normal results. Ectopic ACTH secretion within the small bowel is very rare. This case underscores the difficulty in locating the source of ectopic ACTH secretion and suggests using small bowel barium study, tubus endoscopy or video endoscopy for preoperative localization if the small bowel is suspected as tumor source. |
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Authors:
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J Singer; F Werner; C A Koch; M Bartels; T Aigner; T Lincke; M Fasshauer; R Paschke |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2010-02-16 |
Journal Detail:
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Title: Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association Volume: 118 ISSN: 1439-3646 ISO Abbreviation: Exp. Clin. Endocrinol. Diabetes Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-09-15 Completed Date: 2011-01-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9505926 Medline TA: Exp Clin Endocrinol Diabetes Country: Germany |
Other Details:
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Languages: eng Pagination: 524-9 Citation Subset: IM |
Copyright Information:
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© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York. |
Affiliation:
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Medical Department III, University of Leipzig, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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ACTH Syndrome, Ectopic
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diagnosis*,
etiology Adrenocorticotropic Hormone / secretion* Blood Pressure Carcinoma / complications, diagnosis*, pathology, secretion Cushing Syndrome / diagnosis*, etiology Diabetes Mellitus / etiology Humans Ileal Neoplasms / complications, diagnosis*, pathology, secretion Male Mesentery / surgery Middle Aged Muscle Strength Neuroendocrine Tumors / complications, diagnosis*, pathology, secretion Pituitary Gland / surgery |
| Chemical | |
Reg. No./Substance:
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9002-60-2/Adrenocorticotropic Hormone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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