Severe psychosis due to Cushing's syndrome in a patient with a carcinoid tumour in the lung: a case report and review of the current management.
Severe psychosis in patients with Cushing's syndrome is a rare occurrence and can be extremely resistant to medical therapy. We describe a case of a 51-year-old Afro-Caribbean female patient, with refractory severe hypertension (initially resistant to polypharmacy) and gradual development of severe psychosis secondary to ectopic Cushing's syndrome, who was subsequently diagnosed to have a carcinoid tumour in her lung. Her psychotic episodes - secondary to hypercortisolism and initially refractory to the medical therapy - subsided only after the resection of the carcinoid tumour in her right lower pulmonary lobe. Early localization and appropriate surgical resection of the ectopic ACTH-secreting tumour can be of immense value to the successful alleviation of the psychotic episodes of the patients with ectopic Cushing's syndrome.
Department of Cardiothoracic Surgery, The University Hospital of North Staffordshire NHS Trust, Newcastle Road, Stoke-on-Trent, ST4 6QG, England, UK. mwbaba@hotmail.com.
Mohamad
M
Baba
Department of Cardiothoracic Surgery, The University Hospital of North Staffordshire NHS Trust, Newcastle Road, Stoke-on-Trent, ST4 6QG, England, UK. debamalyaray@hotmail.com.
Debamalya
D
Ray
D002276:Carcinoid Tumor / Q000150:complications*; D003480:Cushing Syndrome / Q000209:etiology*; D019468:Disease Management; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications*; D008875:Middle Aged; D011379:Prognosis; D011618:Psychotic Disorders / Q000209:etiology* / Q000473:pathology / Q000628:therapy*