ArticleAACE endocrinology and diabetes
Cushing Disease Mimicking Ectopic Adrenocorticotropic Hormone-Secreting Disease.
Article in AACE endocrinology and diabetes. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background/Objective: We present the case of a patient whose initial biochemical results suggested an ectopic adrenocorticotropic hormone (ACTH)-secreting tumor, with markedly increased serum ACTH levels, increased 24-hour urinary free cortisol levels, and hypokalemia. Although these features are more commonly associated with ectopic ACTH secretion, the patient was ultimately diagnosed with Cushing disease. Case Report: A 46-year-old man presented with recurrent headaches and progressive skin darkening. He had hypertension and a body mass index of 28.4 kg/m Discussion: Higher urinary and plasma cortisol levels are typical of ectopic ACTH-secreting tumors and likely cause hypokalemia and hypertension, which are encountered more frequently in patients with ectopic ACTH-secreting tumors. In the absence of a pituitary mass 1 cm or more in size, further testing to differentiate Cushing disease from an ectopic source is required. Conclusion: Highly increased serum ACTH and cortisol levels, hypokalemia, and hypertension occur more frequently in patients with ectopic ACTH-secreting tumors. However, we show that they may occur in Cushing disease, and therefore, it would be wrong to assume a diagnosis of an ectopic ACTH-secreting tumor based on these findings alone.
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