title: Unusual triad of obstructive sleep apnea, uncontrolled hypertension, and severe hypokalemia due to ectopic adrenocorticotropic secretion.
abstract: Ectopic adrenocorticotropic hormone secretion is responsible for 12% to 17% of all cases of the Cushing syndrome. One of the most commonly described causes of ectopic adrenocorticotropic hormone secretion is small cell carcinoma of the lung. A rare cause includes a functioning neuroendocrine tumor traditionally known as carcinoids that account for 5% of all mediastinal tumors. To our knowledge, all reported cases of mediastinal carcinoids are thymic in origin and only a minority of those is functional. We present a male patient with hypertension, obstructive sleep apnea, and acid-base disorder, in whom further investigation revealed an anterior mediastinal mass and Cushing syndrome.
authors.affiliation: *Division of Pulmonary and Critical Care Medicine †Division of Pulmonary and Critical Care Medicine Departments of ‡Internal Medicine §Pathology, Bronx Lebanon Hospital Center, Bronx, NY.
authors.forename: Sindhaghatta
authors.initials: S
authors.lastname: Venkatram
authors.forename: Trupti
authors.initials: T
authors.lastname: Vakde
authors.forename: Kanthi
authors.initials: K
authors.lastname: Badipatla
authors.forename: Masooma
authors.initials: M
authors.lastname: Niazi
authors.forename: Gilda
authors.initials: G
authors.lastname: Diaz-Fuentes
mesh_terms: D000182:ACTH Syndrome, Ectopic / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D002637:Chest Pain / Q000209:etiology; D003480:Cushing Syndrome / Q000209:etiology / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D006973:Hypertension / Q000209:etiology*; D007008:Hypokalemia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000150:complications* / Q000000981:diagnostic imaging / Q000378:metabolism; D011859:Radiography; D020181:Sleep Apnea, Obstructive / Q000209:etiology*; D013953:Thymus Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000378:metabolism
chemical_list: D006854:Hydrocortisone