TITLE:
Severe Ectopic Cushing’s Syndrome Due to ACTH-Secreting Pheochromocytoma
AUTHORS:
Aurelio Negro, Enrica Manicardi, Chiara Grasselli, Massimiliano Babini, Rosaria Santi, Valeria Pugni, Lucia Spaggiari, Elena Tagliavini
KEYWORDS:
Cushing’s Syndrome; Pheochromocytoma; Apparent Excess of Mineralocorticoid Syndrome
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.4 No.4,
April
30,
2013
ABSTRACT: We
report a new case of ectopic Cushing’s syndrome caused by an ACTH-producing
pheochromocytoma. A 55-year-old woman
presented with a history of severe proximal muscle weakness, polyuria,
progressive virilization, anxiety, dyspnea on exercise, difficult to treat
hypertension, and type 2 diabetes mellitus since 4 months. The laboratory data
demonstrated ACTH-dependent hypercortisolism. The abdominal computed tomography
scan showed a 30 mm well-defined mass in the left
adrenal gland suggestive for pheochromocytoma. The adrenal veins were sampled,
with intraprocedural cortisol measurement, to dosing
selective ACTH and cathecolamines. The results established clearly the left
adrenal gland as the source of ACTH overproduction. A left sided adrenalectomy
was performed with subsequent resolution of
Cushing’s syndrome. The patient was discharged in good clinical condition.