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Successful Treatment of Severe Ectopic ACTH-Dependent Cushing Syndrome Complicated by Hypocalcemia With Osilodrostat.
JCEM Case Rep
February 2025
Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
Cushing syndrome due to ectopic adrenocorticotropic hormone (ACTH) secretion (EAS) is rare and may progress rapidly, making treatment very challenging. We report a 27-year-old woman with metastatic neuroendocrine tumor (NET) who presented with sudden onset and rapidly progressing fatigue, muscle weakness, and weight gain. Laboratory findings confirmed severe EAS with new onset hypocalcemia, hypokalemia, and hyperglycemia.
View Article and Find Full Text PDFCase report: Pheochromocytoma-induced pseudo-Cushing's syndrome.
Front Endocrinol (Lausanne)
January 2025
Department of Internal Medicine and Endocrinology, University Clinical Centre of the Medical University of Warsaw, Warsaw, Poland.
Article Synopsis
- Non-neoplastic hypercortisolaemia, or pseudo-Cushing's syndrome (PCS), can occur due to various health conditions like depression, obesity, and diabetes, linked to overactivity of the hypothalamic-pituitary-adrenal axis.
- A 66-year-old woman exhibited symptoms such as weakness, weight loss, and poorly controlled hypertension, which led to the discovery of pheochromocytoma, a tumor that causes hormone overproduction, upon further testing.
- After undergoing surgery to remove the tumor and receiving supportive treatment, her symptoms improved significantly, confirming the diagnosis of PCS rather than traditional Cushing's syndrome.
Ectopic ACTH-Dependent Cushing's Syndrome Emerging at a Late Stage of a Mixed Histology Neuroendocrine Neoplasm: A Case Report.
Case Rep Oncol
October 2024
Department of Endocrinology, ENETS Center of Excellence, Hôpital Universitaire de Bruxelles, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
Introduction: Neuroendocrine neoplasms encompass well-differentiated tumors (NETs) and poorly differentiated carcinomas (neuroendocrine carcinomas [NECs]), which are distinguished by their clinical behavior and molecular characteristics. They can cause paraneoplastic syndromes, such as ectopic adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome (CS), necessitating prompt recognition and management due to severe hypercortisolism.
Case Presentation: A 66-year-old patient with a 3-year history of metastatic mixed neuroendocrine-non-neuroendocrine neoplasm with a NEC and adenocarcinoma component originating from the vulva presented to the emergency department with dyspnea and fatigue.
Cushing's Storm: A Case of Paraneoplastic Cushing's Syndrome-Induced Seizures Treated With Continuous Etomidate Infusion.
Cureus
September 2024
Pulmonary and Critical Care Medicine, University of Florida College of Medicine, Jacksonville, USA.
Article Synopsis
- A 67-year-old woman showed signs of abdominal pain, nausea, vomiting, and weight loss, leading to a diagnosis of paraneoplastic Cushing's syndrome caused by small lung cancer.
- Tests indicated high cortisol levels and low potassium, while the patient also experienced severe seizures despite taking several anti-epileptic drugs.
- The treatment involved using continuous etomidate infusion to reduce cortisol levels, highlighting how understanding medication side effects can help in managing complex medical conditions.
Atypical presentation of Cushing's disease with weight loss and hypokalemia.
Endocrinol Diabetes Metab Case Rep
July 2024
Division of Endocrinology and Metabolism, Dalhousie University, Halifax, Nova Scotia, Canada.
Summary: ACTH-secreting pituitary adenomas causing Cushing's disease (CD) typically present with weight gain, whereas weight loss and hypokalemia in endogenous Cushing's patients are suggestive of ectopic ACTH production. We report a case of CD presenting with atypical features of marked weight loss and hypokalemia. A 75-year-old female was admitted to the hospital with a history of profound weight loss, associated with uncontrolled hypertension, hyperglycemia, severe proximal muscle weakness, and hypokalemia.
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