Case 18-2018: A 45-Year-Old Woman with Hypertension, Fatigue, and Altered Mental Status

    June 2018 in “ The New England Journal of Medicine ”
    J. Carl Pallais, Andrew Z. Fenves, Michael T. Lu, Krzysztof Glomski
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    TLDR A woman with Cushing's syndrome improved after surgery to remove a tumor causing the condition.
    In a case study from 2018, a 45-year-old woman with symptoms of Cushing's syndrome was diagnosed with the condition due to ectopic corticotropin secretion from a thymic neuroendocrine tumor. Her symptoms included hypertension, fatigue, altered mental status, hyperglycemia, hypokalemia, and metabolic alkalosis. Diagnostic tests revealed high urinary cortisol and corticotropin levels, and imaging located the ectopic source. The tumor was surgically removed, leading to significant postoperative improvement in her symptoms and allowing her to return to work. The patient's condition was monitored post-surgery without the need for ongoing glucocorticoid replacement, and chemotherapy was considered as a future treatment option if necessary.
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