title: Detection of paranasal ectopic adrenocorticotropic hormone-secreting pituitary adenoma by Ga-68-DOTANOC positron-emission tomography-computed tomography.
abstract: Ectopic adrenocorticotropic hormone (ACTH)-secreting tumors account for approximately 10% of Cushing's syndrome (CS). We present an extremely rare case of a patient with CS caused by an ectopic ACTH-secreting pituitary adenoma (EAPA) of the ethmoid sinus. The tumor was identified by positron-emission tomography-computed tomography (PET/CT) using the somatostatin receptor analogue Ga-68-DOTANOC. Transnasal endoscopic resection was performed and the patient showed significant clinical improvement with normalization of the endocrine pituitary axis. Immunostaining showed a somatostatin receptor 2 and 5-positive ACTH-producing adenoma. In patients with ectopic ACTH secretion, Ga-68-DOTANOC-PET/CT may play an important role in the localization of EAPA. Transnasal endoscopic resection is the therapy of choice.
authors.affiliation: Department of ENT Surgery, University Hospital Ulm, Ulm, Germany. johannes.veit@uniklinik-ulm.de
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Veit
authors.forename: Bernhard
authors.initials: B
authors.lastname: Boehm
authors.forename: Markus
authors.initials: M
authors.lastname: Luster
authors.forename: Angelika
authors.initials: A
authors.lastname: Scheuerle
authors.forename: Nicole
authors.initials: N
authors.lastname: Rotter
authors.forename: Gerhard
authors.initials: G
authors.lastname: Rettinger
authors.forename: Marc
authors.initials: M
authors.lastname: Scheithauer
mesh_terms: D000182:ACTH Syndrome, Ectopic / Q000097:blood / Q000175:diagnosis*; D049913:ACTH-Secreting Pituitary Adenoma / Q000175:diagnosis* / Q000378:metabolism; D000236:Adenoma / Q000175:diagnosis* / Q000378:metabolism; D000324:Adrenocorticotropic Hormone / Q000378:metabolism*; D003937:Diagnosis, Differential; D005710:Gallium Radioisotopes; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009942:Organometallic Compounds; D010255:Paranasal Sinus Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
chemical_list: C504894:68Ga-DOTANOC; D005710:Gallium Radioisotopes; D009942:Organometallic Compounds; D000324:Adrenocorticotropic Hormone