Authors: M D Rodriguez Vaca M Angel I Halperin J Freixenet M Marti M J Martinez Osaba J Sanchez Lloret A Palacin E Vilardell
Publish Date: 2014/03/27
Volume: 10, Issue: 6, Pages: 537-540
Abstract
A 26yrold male was submitted to bilateral adrenalectomy in 1977 for Cushing’s syndrome Some months later he developed intense skin hyperpigmentation together with increased ACTH levels 149 to 4000 ng/l The sellar region was always normal in Xray studies In April 1985 when the patient complained of chest pain a chest xray showed a polycyclic mass in the upper left lobe of the lung ACTH ranged from 20000 to 100000 ng/l with no response to CRF or cyproheptadine administration Urinary 5OHindolacetic acid was negative Thoracotomy was performed in July 1985 with resection of two intrapulmonary masses Histologic study demonstrated a carcinoid tumor with positive neuronspecific enolase and ACTH immunochemical stain ACTH concentration in tumoral tissue was 91 pg/g tissue After surgery ACTH fell dramatically to 37 ng/l and has remained at this level since then associated with resolution of the skin hyperpigmentation
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