ArticleCureus2026
Hidden in the Mediastinum: A Grade 1 Neuroendocrine Tumor Revealed by Refractory Hypokalemia and Ectopic Adrenocorticotropic Hormone (ACTH)-Dependent Cushing's Syndrome.
Article in Cureus, 2026. 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
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Ectopic adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome (CS) is a rare, fulminant variant of endogenous hypercortisolism that demands rapid localization of the ACTH source to achieve a cure. A 51-year-old woman presented with progressive proximal muscle weakness, centripetal obesity, new-onset hypertension with a blood pressure of 150/90 mmHg at arrival, and persistent hypokalemia (2.2 mmol/L). Biochemical testing confirmed severe hypercortisolism that failed to suppress after an overnight 1-mg dexamethasone test. Plasma ACTH was markedly elevated (798 pg/mL), indicating ACTH-dependent disease. Pituitary MRI showed no adenoma, so an ectopic source was suspected. Contrast-enhanced thoracoabdominal CT revealed a 24 × 14-mm anterior mediastinal node, which was excised via video-assisted thoracoscopic surgery (VATS). Histopathology confirmed a grade 1 neuroendocrine tumor with diffuse positivity for synaptophysin, chromogranin A, and neuron-specific enolase. Twenty-four hours after surgery, serum cortisol decreased to 11.1 µg/dL and ACTH to 2.0 pg/mL; serum potassium normalized without supplementation. Octreotide receptor scintigraphy showed no residual or metastatic disease, and the patient remained normotensive and normokalemic at follow-up. Rapidly progressive hypercortisolism accompanied by refractory hypokalemia should prompt consideration of ectopic ACTH secretion. A stepwise diagnostic approach, including biochemical confirmation, exclusion of pituitary disease, and targeted thoracic localization, enabled early minimally invasive resection and biochemical cure in this case. Early recognition and surgery remain the cornerstones of management for ectopic ACTH-producing neuroendocrine tumors. Prompt identification and anatomical localization of the ectopic source are essential to prevent prolonged exposure to severe hypercortisolism and its associated metabolic and cardiovascular complications. Timely surgical resection allows rapid biochemical remission and improvement in short- and long-term outcomes.
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.