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Case report
Possible pitfalls in the workup of ectopic ACTH secretion illustrated by four rare cases
  1. Jorianne Boers1,
  2. P Christine Oldenburg-Ligtenberg1,
  3. Aline ME Stades2 and
  4. Mark JC van Treijen3
  1. 1 Department of Internal Medicine, Meander Medical Centre, Amersfoort, Utrecht, The Netherlands
  2. 2 Department of Endocrinology, University Medical Center Utrecht, Utrecht, The Netherlands
  3. 3 Department of Endocrine Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
  1. Correspondence to Mr Mark JC van Treijen; M.J.C.vanTreijen{at}


In this case report, we highlight four different cases of ectopic adrenocorticotropic hormone (ACTH) secretion with different pitfalls in the diagnostic workup. Ectopic ACTH secretion (EAS) is an uncommon cause of Cushing’s syndrome that accompanies a variety of tumours. It is associated with significant morbidity and mortality. This underlines the importance of early and adequate diagnosis. We will review the causes of EAS and their presentation to increase awareness of this rare and progressive disease.

  • endocrinology
  • metabolic disorders
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  • Contributors JB and MJCvT are both responsible for writing the manuscript and preparing the figures and tables. AMES and PCO-L reviewed the manuscript. All authors approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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