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Cushing syndrome due to ectopic ACTH secreting pheochromocytoma
  1. Muhammad Naeem Durrani1 and
  2. Ubaidullah Popal2
  1. 1The Aga Khan University Hospital Main Campus Karachi, Karachi, Pakistan
  2. 2Tabba Heart Institute, Karachi, Pakistan
  1. Correspondence to Dr Ubaidullah Popal; dr_ubaid88{at}yahoo.com

Abstract

In this case report, we present a case of a woman in her late 30s who presented with bilateral motor weakness, headache, hyperglycaemia and hypertension. Investigations revealed very high 24-hour urine cortisol of 90 524, ectopic adrenocorticotropic hormone secreting pheochromocytoma, normal metanephrine levels and empty sella, which has never been reported. CT chest and abdomen revealed enlarged left adrenal gland with large necrotic mass 4.7×4.0 cm most likely neoplastic lesion. The patient was cured after surgical removal of the left adrenal mass. Histological examination revealed 3.5×2.5×2 cm mass consistent with pheochromocytoma. After surgery and a short stay in the intensive care unit, the patient started improving and both antihypertensive treatment and insulin injections were withdrawn.

  • Adrenal disorders
  • Medical management

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Footnotes

  • Contributors MND and UP: conception and design, acquisition of data oranalysis and interpretation of data. MND and UP: Drafting the article or revising it critically for important intellectual content. MND and UP: Final approval of the version published. MND and UP: Agreement to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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