Challenges in The Diagnosis and Management of Cushing’s Syndrome due to Ectopic ACTH Caused by Pulmonary Carcinoid Tumor in a Patient with Pneumoconiosis.

Authors

Hazim BukamurFollow
Chelsey White, Marshall UniversityFollow
Rodhan Khthir, Marshall UniversityFollow
Alysia Browne, Marshall UniversityFollow
Fauzi Najar, Marshall UniversityFollow
Mohammed Al-Ourani, Marshall UniversityFollow

Document Type

Article

Publication Date

7-1-2018

Abstract

Sites with a high prevalence of pneumoconiosis are especially challenging to physicians. The presence of pneumoconiotic nodules on the chest computerized tomography (CT) scans makes it difficult to localize the source of ectopic adrenocorticotropic hormone (ACTH). Because of false-positive results that may occur with the use of 18 fluorodeoxyglucose ( [¹⁸F]FDG) Positron emission tomography CT (PET/CT) scan, alternative imaging modalities are needed. Gallium [⁶⁸Ga]DOTATATE is a positron emitter-labeled somatostatin analog used with PET/CT, which may improve the diagnostic accuracy of localizing ectopic ACTH-secreting carcinoid tumors in patients with pneumoconiosis by reducing false-positive results. We describe a patient with pneumoconiosis and Cushing’s syndrome due to ectopic ACTH from a pulmonary carcinoid tumor, highlighting challenges in diagnosis and management. Prospective studies to compare [¹⁸F]FDG PET/CT with [⁶⁸Ga]DOTATATE PET/CT for diagnosis of bronchial carcinoid tumors in patients with ectopic ACTH and pneumoconiosis are highly needed. We also review the scarcely available literature and provide recommendations based on our experience with this case.

Recommended Citation

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