title: Diagnostic difficulties in periodic Cushing's syndrome.
abstract: A 22-year-old black woman presented with symptoms suggestive of Cushing's syndrome three years after chemotherapy for a presumed teratoma with cervical lymphadenopathy. Initially, the absence of clinical signs and the demonstration of two normal 24 h urinary free cortisols appeared to exclude the diagnosis, but an ectopic adrenocorticotropin-producing thymic carcinoid was subsequently removed surgically. Cushing's syndrome due to ectopic adrenocorticotropin production can be difficult to diagnose, particularly if there is periodic hormonogenesis.
authors.affiliation: Department of Medicine, Royal Liverpool University Hospital, UK.
authors.forename: A B
authors.initials: AB
authors.lastname: Walker
authors.forename: G P
authors.initials: GP
authors.lastname: Leese
authors.forename: J P
authors.initials: JP
authors.lastname: Vora
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000378:metabolism*; D000328:Adult; D002276:Carcinoid Tumor / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D003480:Cushing Syndrome / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010507:Periodicity; D013899:Thoracic Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D013945:Thymoma / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism
chemical_list: D000324:Adrenocorticotropic Hormone