Cushing's syndrome produced by bronchial carcinoid associated with hypophyseal adenoma
Morán, C.; Flores, M.; Loyo, M.; Rivas, A.; Zárate, A.
Archivos de Investigacion Medica 16(1): 111-118
1985
ISSN/ISBN: 0066-6769 PMID: 4015294 Document Number: 261494
A case is reported of a woman 17 yr old with ectopic Cushing's syndrome, which presented diagnostic difficulties, because initially it was thought to be a hypophyseal adenoma. The patient had typical clinical manifestations, hypercortisolism, elevated 17-OH in the urine, high ACTH values, loss of circadian rhythm of cortisol and paradoxical reaction to the administration of dexamethasone. Since the X-ray image was compatible with hypophyseal microadenoma, she initially underwent transphenoidal adenomectomy, with histopathological confirmation of the diagnosis. After the operation, hypercortisolism persisted with severe hypokalemic alkalosis, due to which she underwent hypophysectomy. The patient died 30 days after the 2nd operation with multiple infectious complications and acute pulmonary edema. The necropsy revealed an ACTH producing bronchial carcinoid, demonstrated by the immunoperoxidase technique.