ArticleAACE endocrinology and diabetes
Ectopic Adrenocorticotropic Hormone Syndrome Secondary to Pulmonary Neuroendocrine Tumor: Medical Stabilization Enables Serial Imaging and Localization.
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.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Ectopic adrenocorticotropic hormone (ACTH) syndrome accounts for 15% to 20% of Cushing syndrome cases with unique diagnostic challenges. Tumor localization remains difficult, with approximately 20% of cases having occult sources despite extensive imaging. This report describes a patient whose initially occult tumor was successfully localized through serial imaging enabled by medical stabilization, resulting in curative surgical resection. Case Presentation: Thirty-nine-year-old woman presented with progressive weight gain, new-onset hypertension, hypokalemia, proximal muscle weakness, and cushingoid features. Laboratory evaluation demonstrated severe hypercortisolism with markedly elevated ACTH levels, and inferior petrosal sinus sampling confirmed the diagnosis of ectopic ACTH syndrome. Despite comprehensive imaging-including cross-sectional studies, gallium-68 (68Ga)-DOTA-D-Phe1,Tyr3-octreotate positron emission tomography/computed tomography, and FDG PET/CT-the ectopic source remained elusive. Medical therapy with ketoconazole and metyrapone achieved rapid biochemical control. An 8 mm lingular pulmonary nodule, non-avid on both DOTATATE and FDG PET but identified on the CT portion of FDG PET/CT, was surgically resected, resulting in complete biochemical cure. Discussion: This case highlights medical stabilization's critical role when tumor localization is initially unsuccessful, enabling serial anatomic imaging that identified an 8 mm pulmonary carcinoid initially obscured by atelectasis and nonavid on functional imaging. Small, well-differentiated neuroendocrine tumors can cause severe hypercortisolism, yet remain undetectable on DOTATATE and FDG PET. Conclusion: This case demonstrates that medical stabilization achieves rapid biochemical control, providing time for serial anatomic imaging to localize occult ectopic ACTH sources. A small pulmonary carcinoid initially obscured by atelectasis and non:avid on functional imaging was identified through repeat CT comparison, enabling curative resection and avoiding bilateral adrenalectomy.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.