[ACTH's ectopic secretion in a patient with precedents of Cushing's disease].
A 54-year-old man, with a history of Cushing's disease diagnosed 32 years earlier, presented with edema, asthenia and general malaise. Abnormal laboratory studies depicted hypokalemia and metabolic alkalosis. A CT scan of the chest revealed a 3×3 cm tumor in the anterior mediastinum. The pathology was consistent with a thymic carcinoid. These findings led to a diagnosis of biochemical Cushing's syndrome secondary to ectopic secretion of ACTH. Thus, this patient suffered twice of Cushing's syndrome. The first instance was the consequence of an ACTH--secreting pituitary adenoma and the second of an ectopic secretion of ACTH. To the best of our knowledge this is the first such case reported in the medical literature.
Servicio de Clínica Médica, Sanatorio San José, Buenos Aires, Argentina. E-mail: agustindalverme@gmail.com.
Agustín
A
Dal Verme
Carlos
C
Cejas
Mercedes
M
Margan
Daniel
D
Siguelboim
Victoria
V
Canosa
Christian
C
Peralta
D000182:ACTH Syndrome, Ectopic / Q000175:diagnosis / Q000209:etiology*; D003480:Cushing Syndrome; D006801:Humans; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000150:complications* / Q000175:diagnosis; D013953:Thymus Neoplasms / Q000150:complications* / Q000175:diagnosis
Cushing's disease; ectopic secretion of ACTH; thymic carcinoid