Complete Tumor Resection and Radical Lymphadenectomy: Potential Cure for Adrenocorticotropic Hormone (ACTH)-Dependent Pulmonary Carcinoid.

Autor:	Elsheikh A; Endocrinology, Diabetes, and Metabolism, UCHealth Anschutz Outpatient Pavilion, Anschutz Medical Campus, Aurora, USA., Harbuz-Miller I; Endocrinology and Metabolism, University of Rochester School of Medicine and Dentistry, Rochester, USA., Vates E; Neurosurgery, University of Rochester School of Medicine and Dentistry, Rochester, USA., Nead M; Pulmonary and Critical Care Medicine, University of Rochester School of Medicine and Dentistry, Rochester, USA., Shafiq I; Endocrinology and Metabolism, University of Rochester School of Medicine and Dentistry, Rochester, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Nov 11; Vol. 16 (11), pp. e73438. Date of Electronic Publication: 2024 Nov 11 (Print Publication: 2024).
DOI:	10.7759/cureus.73438
Abstrakt:	Ectopic adrenocorticotropic hormone (ACTH)-dependent Cushing is a rare syndrome. We present a case that illustrates the diagnostic and therapeutic challenges of ectopic Cushing. A 35-year-old woman presented to the outpatient clinic for evaluation of progressive weight gain, muscle weakness, easy bruising, uncontrolled hypertension, and hyperglycemia. Biochemical workup revealed elevated salivary cortisol and 24-hour urine cortisol; the baseline ACTH was elevated, consistent with ACTH-dependent hypercortisolemia. Imaging showed a pituitary microadenoma and a lung nodule. Inferior petrosal sinus sampling was suggestive of an ectopic source. Medical treatment was employed to manage acute hypercortisolemia with a resolution of symptoms. A biopsy of the lung nodule showed the neuroendocrine tumor. Surgical treatment with pulmonary wedge resection did not alleviate hypercortisolemia, leading to repeat surgery with radical lymph node dissection, which resulted in the resolution of hypercortisolemia. This case illustrates that radical lymph node dissection, along with tumor resection, has a high likelihood of cure. Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Elsheikh et al.)
Databáze:	MEDLINE
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