ACTH-Dependent Cushing's Syndrome Due to Metastatic Cervical Cancer: A Case Report

    October 2024 in “ Journal of the Endocrine Society ”
    Tiago Donizeti Bertolacini da Silva, Tiago Bertolacini, Victor da Costa Kamura, Pedro de Figueiredo Buchalla, Alexandre Gomes Sibanto Simões, Sidney Glina, Zélia Maria de Sousa Campos, Isabelle Rosa, Patrícia Xavier Santi
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    TLDR ACTH-dependent Cushing's syndrome linked to metastatic cervical cancer is rare and has high risks.
    This case report describes a rare instance of ACTH-dependent Cushing's syndrome caused by metastatic cervical cancer in a 39-year-old woman. The patient initially presented with symptoms such as abnormal uterine bleeding and was diagnosed with endometrioid adenocarcinoma. After initial treatment, she developed symptoms consistent with Cushing's syndrome, including hypertension, hyperglycemia, and hirsutism. Laboratory tests confirmed elevated levels of ACTH and cortisol. Imaging revealed metastatic disease in the liver and enlarged adrenal glands. Despite treatment attempts with Etomidate and Ketoconazole, the patient underwent bilateral adrenalectomy but unfortunately died from septic shock shortly after surgery. This case highlights the diagnostic challenges and high morbidity and mortality associated with this rare condition, with fewer than 10 cases reported in the literature.
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