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.
    This case study described a 30-year-old female with Cushing syndrome (CS) due to ectopic ACTH secretion (EAS) from a neuroendocrine lung tumor. The patient presented with symptoms such as fatigue, muscle weakness, weight gain, hair loss, and amenorrhea. Initial tests showed elevated cortisol and ACTH levels, and a chest X-ray revealed lung masses, avoiding the need for invasive inferior petrosal sinus sampling (IPSS). A lung biopsy confirmed a well-differentiated neuroendocrine tumor. Post-surgery, the patient's hormone levels normalized, and she remained asymptomatic at a 6-month follow-up. The study highlighted the importance of considering EAS in CS cases without visible pituitary adenomas and the utility of chest X-rays in identifying ectopic sources.
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