Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access
Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc
Journal website https://www.jofem.org

Case Report

Volume 13, Number 4, November 2023, pages 164-169

A Challenging Case of Cushing’s Syndrome Due to Ectopic Adrenocorticotropic Hormone Secretion

Figures

Figure 1.
Figure 1. A sagittal view of the computed tomography of head with contrast showing pituitary microadenoma.
Figure 2.
Figure 2. Abdomen CT scan showing bilaterally adrenal hyperplasia (arrows). CT: computed tomography.
Figure 3.
Figure 3. Axial CT scan of the neck showing heterogeneous nodular mass with macrocalcifications in the right thyroid lobe. CT: computed tomography.
Figure 4.
Figure 4. Coronal CT scan of the neck showing heterogeneous nodular mass with macrocalcifications in the right thyroid lobe. CT: computed tomography.

Table

Table 1. Laboratory Values of the Patient
 
ParametersValuesReference values
FBG: fasting blood glucose; HbA1c: glycated hemoglobin; PTC: plasma total cortisol; UFC: urine free cortisol; ACTH: adrenocorticotropic hormone; DST: dexamethasone suppression test; FT4: free thyroxine; TSH: thyroid-stimulating hormone.
FBG (mg/dL)16782 - 115
HbA1c (%)104 - 6
Serum potassium (mmol/L)1.93.5 - 5.1
Serum sodium (mmol/L)150136 - 145
8 am PTC (nmol/L)2,039101 - 535
11 pm PTC (nmol/L)1, 923 (1:2 serum dilution)79 - 478
24-h UFC (nmol/24 h)15,55511.8 - 485
ACTH (pg/mL)3465 - 46
1 mg DST (nmol/L)2,754< 50
8 mg DST (nmol/L)2,142< 50
Serum calcitonin (pg/mL)713< 5.0
FT4 (pmol/L)8.769 - 19
TSH (µUI/mL)1.990.35 - 4.94
Chromogranin A (ng/mL)182.2< 101.9
Carcinoembryonic antigen (ng/mL)11.66< 5.0
Metanephrines (pg/mL)72< 90
Normetanephrines (pg/mL)65.1< 180