title: ACTH producing pulmonary carcinoid and pituitary macroadenoma: a fortuitous association?
abstract: We report a case of a 45 year-old man who presented initially with a non-functioning pituitary macroadenoma. A routine chest radiography done preoperatively revealed a right lung nodule which was confirmed by computed tomography (CT) of the thorax. Transfrontal hypophysectomy was performed while a conservative approach was taken for the lung nodule. Four years later, he presented acutely with adrenocorticotrophic hormone (ACTH) dependent Cushing's syndrome which resolved following a right lobectomy. Histological examination revealed an atypical carcinoid. To our knowledge, this is the first reported case of an ectopic ACTH secreting pulmonary carcinoid found in association with a non-functioning pituitary macroadenoma.
authors.affiliation: Department of Medicine, National University of Malaysia, Jalan Yaacob Latiff, Cheras, 56000 Kuala Lumpur.
authors.forename: M
authors.initials: M
authors.lastname: Wong
authors.forename: S H Md
authors.initials: SH
authors.lastname: Isa
authors.forename: N A
authors.initials: NA
authors.lastname: Kamaruddin
authors.forename: B A K
authors.initials: BA
authors.lastname: Khalid
mesh_terms: D000182:ACTH Syndrome, Ectopic / Q000150:complications* / Q000473:pathology; D002276:Carcinoid Tumor / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications* / Q000473:pathology