Ectopic ACTH Syndrome Associated with Large Cell Neuroendocrine Carcinoma of the Thymus
A 38-year-old man was admitted for evaluation of Cushing's syndrome. Physical findings showed swelling of the face, and hypertension, but not Cushingoid stigmata. Laboratory data revealed serum cortisol level of 34.1 μg/dL and plasma ACTH of 140 pg/mL. Overnight administration of 1 and 8 mg dex...
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| Veröffentlicht in: | Internal Medicine 2011, Vol.50(14), pp.1471-1475 |
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| container_title | Internal Medicine |
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| creator | Saito, Tomoyuki Kimoto, Mizuho Nakai, Syuichi Ikoma, Aki Toyoshima, Hideo Kawakami, Masanobu Nokubi, Mitsuhiro Ishikawa, San-e |
| description | A 38-year-old man was admitted for evaluation of Cushing's syndrome. Physical findings showed swelling of the face, and hypertension, but not Cushingoid stigmata. Laboratory data revealed serum cortisol level of 34.1 μg/dL and plasma ACTH of 140 pg/mL. Overnight administration of 1 and 8 mg dexamethasone did not suppress plasma ACTH or serum cortisol. Chest X-ray showed a mass at the upper-anterior quadrant of the mediastinum, and chest CT scan revealed a heterogenous tumor of approximately 60 mm in diameter, which infiltrated into the superior vena cava and ascending aorta, and caused superior vena cava syndrome. The tumor was resected. Histological examination indicated large cell neuroendocrine carcinoma of the thymus and positive immunoreactivity for ACTH. Ten days after the operation, the plasma ACTH decreased as low as 13.7 pg/mL. The present study indicates that large cell neuroendocrine carcinoma of the thymus can cause superior vena cava syndrome and ectopic ACTH syndrome. |
| doi_str_mv | 10.2169/internalmedicine.50.5160 |
| format | Article |
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Physical findings showed swelling of the face, and hypertension, but not Cushingoid stigmata. Laboratory data revealed serum cortisol level of 34.1 μg/dL and plasma ACTH of 140 pg/mL. Overnight administration of 1 and 8 mg dexamethasone did not suppress plasma ACTH or serum cortisol. Chest X-ray showed a mass at the upper-anterior quadrant of the mediastinum, and chest CT scan revealed a heterogenous tumor of approximately 60 mm in diameter, which infiltrated into the superior vena cava and ascending aorta, and caused superior vena cava syndrome. The tumor was resected. Histological examination indicated large cell neuroendocrine carcinoma of the thymus and positive immunoreactivity for ACTH. Ten days after the operation, the plasma ACTH decreased as low as 13.7 pg/mL. The present study indicates that large cell neuroendocrine carcinoma of the thymus can cause superior vena cava syndrome and ectopic ACTH syndrome.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.50.5160</identifier><identifier>PMID: 21757832</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>ACTH Syndrome, Ectopic - diagnosis ; Adrenocorticotropic Hormone - blood ; Adrenocorticotropic Hormone - metabolism ; Adult ; Carcinoma, Neuroendocrine - diagnosis ; Carcinoma, Neuroendocrine - metabolism ; Carcinoma, Neuroendocrine - surgery ; Cushing Syndrome - diagnosis ; Cushing's syndrome ; ectopic ACTH syndrome ; Humans ; Hydrocortisone - blood ; LCNEC ; Male ; neuroendocrine carcinoma ; superior vena cava syndrome ; Thymus Neoplasms - diagnosis ; Thymus Neoplasms - metabolism ; Thymus Neoplasms - surgery</subject><ispartof>Internal Medicine, 2011, Vol.50(14), pp.1471-1475</ispartof><rights>2011 by The Japanese Society of Internal Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c444t-413cf196bed5e55c0106a2ce7cd5869d42fd3509e2913e682ab0d9f46c2fb2473</citedby><cites>FETCH-LOGICAL-c444t-413cf196bed5e55c0106a2ce7cd5869d42fd3509e2913e682ab0d9f46c2fb2473</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1881,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21757832$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Saito, Tomoyuki</creatorcontrib><creatorcontrib>Kimoto, Mizuho</creatorcontrib><creatorcontrib>Nakai, Syuichi</creatorcontrib><creatorcontrib>Ikoma, Aki</creatorcontrib><creatorcontrib>Toyoshima, Hideo</creatorcontrib><creatorcontrib>Kawakami, Masanobu</creatorcontrib><creatorcontrib>Nokubi, Mitsuhiro</creatorcontrib><creatorcontrib>Ishikawa, San-e</creatorcontrib><title>Ectopic ACTH Syndrome Associated with Large Cell Neuroendocrine Carcinoma of the Thymus</title><title>Internal Medicine</title><addtitle>Intern. Med.</addtitle><description>A 38-year-old man was admitted for evaluation of Cushing's syndrome. Physical findings showed swelling of the face, and hypertension, but not Cushingoid stigmata. Laboratory data revealed serum cortisol level of 34.1 μg/dL and plasma ACTH of 140 pg/mL. Overnight administration of 1 and 8 mg dexamethasone did not suppress plasma ACTH or serum cortisol. Chest X-ray showed a mass at the upper-anterior quadrant of the mediastinum, and chest CT scan revealed a heterogenous tumor of approximately 60 mm in diameter, which infiltrated into the superior vena cava and ascending aorta, and caused superior vena cava syndrome. The tumor was resected. Histological examination indicated large cell neuroendocrine carcinoma of the thymus and positive immunoreactivity for ACTH. Ten days after the operation, the plasma ACTH decreased as low as 13.7 pg/mL. The present study indicates that large cell neuroendocrine carcinoma of the thymus can cause superior vena cava syndrome and ectopic ACTH syndrome.</description><subject>ACTH Syndrome, Ectopic - diagnosis</subject><subject>Adrenocorticotropic Hormone - blood</subject><subject>Adrenocorticotropic Hormone - metabolism</subject><subject>Adult</subject><subject>Carcinoma, Neuroendocrine - diagnosis</subject><subject>Carcinoma, Neuroendocrine - metabolism</subject><subject>Carcinoma, Neuroendocrine - surgery</subject><subject>Cushing Syndrome - diagnosis</subject><subject>Cushing's syndrome</subject><subject>ectopic ACTH syndrome</subject><subject>Humans</subject><subject>Hydrocortisone - blood</subject><subject>LCNEC</subject><subject>Male</subject><subject>neuroendocrine carcinoma</subject><subject>superior vena cava syndrome</subject><subject>Thymus Neoplasms - diagnosis</subject><subject>Thymus Neoplasms - metabolism</subject><subject>Thymus Neoplasms - surgery</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkMtOwzAQRS0EoqXwC8g_kOJnEi-rCChSRRcUsYwce9K6yqOyXaH-PalaukBsZhZz752ZgxCmZMpoqp5cF8F3umnBOuM6mEoylTQlV2hMuVBJxri8RmOiaJ6woYzQXQhbQnieKXaLRoxmMss5G6OvZxP7nTN4Vqzm-OPQWd-3gGch9MbpCBZ_u7jBC-3XgAtoGvwOe99DZ3vjh8240H64oG817mscN4BXm0O7D_foptZNgIdzn6DPl-dVMU8Wy9e3YrZIjBAiJoJyU1OVVmAlSGkIJalmBjJjZZ4qK1htuSQKhi84pDnTFbGqFqlhdcVExicoP-Ua34fgoS533rXaH0pKyiOr8i-rUpLyyGqwPp6su301DC_GXziDYHkSbEPUa7gItI_ONPBvMhXnSkVGL0qz0b6Ejv8AibyISA</recordid><startdate>20110101</startdate><enddate>20110101</enddate><creator>Saito, Tomoyuki</creator><creator>Kimoto, Mizuho</creator><creator>Nakai, Syuichi</creator><creator>Ikoma, Aki</creator><creator>Toyoshima, Hideo</creator><creator>Kawakami, Masanobu</creator><creator>Nokubi, Mitsuhiro</creator><creator>Ishikawa, San-e</creator><general>The Japanese Society of Internal Medicine</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20110101</creationdate><title>Ectopic ACTH Syndrome Associated with Large Cell Neuroendocrine Carcinoma of the Thymus</title><author>Saito, Tomoyuki ; Kimoto, Mizuho ; Nakai, Syuichi ; Ikoma, Aki ; Toyoshima, Hideo ; Kawakami, Masanobu ; Nokubi, Mitsuhiro ; Ishikawa, San-e</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c444t-413cf196bed5e55c0106a2ce7cd5869d42fd3509e2913e682ab0d9f46c2fb2473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>ACTH Syndrome, Ectopic - diagnosis</topic><topic>Adrenocorticotropic Hormone - blood</topic><topic>Adrenocorticotropic Hormone - metabolism</topic><topic>Adult</topic><topic>Carcinoma, Neuroendocrine - diagnosis</topic><topic>Carcinoma, Neuroendocrine - metabolism</topic><topic>Carcinoma, Neuroendocrine - surgery</topic><topic>Cushing Syndrome - diagnosis</topic><topic>Cushing's syndrome</topic><topic>ectopic ACTH syndrome</topic><topic>Humans</topic><topic>Hydrocortisone - blood</topic><topic>LCNEC</topic><topic>Male</topic><topic>neuroendocrine carcinoma</topic><topic>superior vena cava syndrome</topic><topic>Thymus Neoplasms - diagnosis</topic><topic>Thymus Neoplasms - metabolism</topic><topic>Thymus Neoplasms - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Saito, Tomoyuki</creatorcontrib><creatorcontrib>Kimoto, Mizuho</creatorcontrib><creatorcontrib>Nakai, Syuichi</creatorcontrib><creatorcontrib>Ikoma, Aki</creatorcontrib><creatorcontrib>Toyoshima, Hideo</creatorcontrib><creatorcontrib>Kawakami, Masanobu</creatorcontrib><creatorcontrib>Nokubi, Mitsuhiro</creatorcontrib><creatorcontrib>Ishikawa, San-e</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Internal Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Saito, Tomoyuki</au><au>Kimoto, Mizuho</au><au>Nakai, Syuichi</au><au>Ikoma, Aki</au><au>Toyoshima, Hideo</au><au>Kawakami, Masanobu</au><au>Nokubi, Mitsuhiro</au><au>Ishikawa, San-e</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ectopic ACTH Syndrome Associated with Large Cell Neuroendocrine Carcinoma of the Thymus</atitle><jtitle>Internal Medicine</jtitle><addtitle>Intern. Med.</addtitle><date>2011-01-01</date><risdate>2011</risdate><volume>50</volume><issue>14</issue><spage>1471</spage><epage>1475</epage><pages>1471-1475</pages><issn>0918-2918</issn><eissn>1349-7235</eissn><abstract>A 38-year-old man was admitted for evaluation of Cushing's syndrome. Physical findings showed swelling of the face, and hypertension, but not Cushingoid stigmata. Laboratory data revealed serum cortisol level of 34.1 μg/dL and plasma ACTH of 140 pg/mL. Overnight administration of 1 and 8 mg dexamethasone did not suppress plasma ACTH or serum cortisol. Chest X-ray showed a mass at the upper-anterior quadrant of the mediastinum, and chest CT scan revealed a heterogenous tumor of approximately 60 mm in diameter, which infiltrated into the superior vena cava and ascending aorta, and caused superior vena cava syndrome. The tumor was resected. Histological examination indicated large cell neuroendocrine carcinoma of the thymus and positive immunoreactivity for ACTH. Ten days after the operation, the plasma ACTH decreased as low as 13.7 pg/mL. The present study indicates that large cell neuroendocrine carcinoma of the thymus can cause superior vena cava syndrome and ectopic ACTH syndrome.</abstract><cop>Japan</cop><pub>The Japanese Society of Internal Medicine</pub><pmid>21757832</pmid><doi>10.2169/internalmedicine.50.5160</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | ACTH Syndrome, Ectopic - diagnosis Adrenocorticotropic Hormone - blood Adrenocorticotropic Hormone - metabolism Adult Carcinoma, Neuroendocrine - diagnosis Carcinoma, Neuroendocrine - metabolism Carcinoma, Neuroendocrine - surgery Cushing Syndrome - diagnosis Cushing's syndrome ectopic ACTH syndrome Humans Hydrocortisone - blood LCNEC Male neuroendocrine carcinoma superior vena cava syndrome Thymus Neoplasms - diagnosis Thymus Neoplasms - metabolism Thymus Neoplasms - surgery |
| title | Ectopic ACTH Syndrome Associated with Large Cell Neuroendocrine Carcinoma of the Thymus |
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