Cushing Syndrome Secondary to Neuroendocrine Lung Carcinoma: To X-Ray or Not to X-Ray?

    April 2019 in “ Journal of the Endocrine Society ”
    Abir Zainal, Omeleye Akinsola, Krishnakumar Rajamani
    TLDR A chest X-ray can effectively diagnose ectopic ACTH secretion from lung tumors.
    The document described a rare case of ectopic ACTH secretion (EAS) due to a primary lung neuroendocrine tumor (NET) in a 30-year-old female, presenting with symptoms like fatigue, muscle weakness, and hair loss. Despite normal vital signs, tests revealed elevated cortisol and ACTH levels, confirming EAS. A chest X-ray identified lung masses, avoiding the need for invasive inferior petrosal sinus sampling (IPSS). A biopsy confirmed a well-differentiated NET, and post-surgical treatment led to normalization of ACTH, blood glucose, and cortisol levels. The case highlighted that EAS should be suspected if a pituitary adenoma is not visible on MRI, and a simple chest X-ray can be a useful diagnostic tool. The patient remained asymptomatic at a 6-month follow-up.
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