Localization and postoperative follow-up of a bronchial carcinoid tumor causing Cushing's syndrome by 111In-DTPA labelled octreotide scintigraphy.
Bronchial carcinoid tumor is the most frequent occult source of ectopic ACTH-dependent Cushing's syndrome, but its initial localization may be very difficult, as well as its postoperative follow-up. We here present the case of a 21-year-old man with Cushing's syndrome and biochemical findings suggesting an ectopic source of ACTH (lack of inhibition of cortisol after overnight 8-mg dexamethasone suppression test, and lack of response to h-CRH challenge). Chest CT-scan showed a node adjacent to the left lung hilium whose nature was confirmed by uptake of 111Indium-DTPA labelled octreotide scintigraphy. Surgical resection of the tumor consisted in an upper lobectomy of the left lung. Microscopic examination identified a typical carcinoid tumor. After surgery pituitary-adrenal function normalized and a second scintigraphy offered additional data on the absence of tumor remnants.
Fernandez-Fernandez
F
F
Endocrinology and Nutrition Unit, Hospital Clinic, Barcelona, Spain.
Halperin
I
I
Manzanares
J M
JM
Flores
L
L
Lomeña
F
F
Vilardell
E
E
D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D001984:Bronchial Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D002276:Carcinoid Tumor / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D003480:Cushing Syndrome / Q000209:etiology*; D003907:Dexamethasone; D005938:Glucocorticoids; D006801:Humans; D007205:Indium Radioisotopes; D007700:Kinetics; D008297:Male; D015282:Octreotide; D004369:Pentetic Acid; D011877:Radionuclide Imaging
D005938:Glucocorticoids; D007205:Indium Radioisotopes; D004369:Pentetic Acid; D003907:Dexamethasone; D000324:Adrenocorticotropic Hormone; D015282:Octreotide