A case of ectopic ACTH secretion
We report the case of a 48-year-old woman, with a rapidly progressing ACTH neuroendocrine tumour of the pancreas (PNET) and multiple liver metastases. The patient had previously suffered from a peptic ulcer which was responsive to PPI inhibitors and hypertension which was poorly controlled by therap...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SEEd
2015-10-01
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| Series: | Clinical Management Issues |
| Subjects: | |
| Online Access: | https://journals.seedmedicalpublishers.com/index.php/cmi/article/view/492 |
| _version_ | 1818146722772156416 |
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| author | Monica Cevenini Elena Guidetti Maria Camilla Fabbri Eleonora Galassi Paola Tomassetti Roberto Corinaldesi |
| author_facet | Monica Cevenini Elena Guidetti Maria Camilla Fabbri Eleonora Galassi Paola Tomassetti Roberto Corinaldesi |
| author_sort | Monica Cevenini |
| collection | DOAJ |
| description | We report the case of a 48-year-old woman, with a rapidly progressing ACTH neuroendocrine tumour of the pancreas (PNET) and multiple liver metastases. The patient had previously suffered from a peptic ulcer which was responsive to PPI inhibitors and hypertension which was poorly controlled by therapy. Admitted to the hospital for severe asthenia and abdominal pain, she was diagnosed with poorly differentiated PNET with liver metastases, which were positive for synaptophysin, cytokeratin 7 and 9 and neuron specific enolase (NSE). Octreoscan scintigraphy was positive for somatostatin receptors in the pancreas and in two liver lesions. A rapidly progressive Cushing’s syndrome developed, presenting with the classical physical symptoms, hypokalemia and Lysteria monocytogenes meningitis. Ectopic ACTH production was confirmed and eventually the patient died from a septic shock within two months. The case reported focuses on the malignity and the rapid progression of an ACTH-producing PNET and calls attention to the possible fatal progression of these cases. |
| first_indexed | 2024-12-11T12:23:52Z |
| format | Article |
| id | doaj.art-e81c78d6ce8e46f9a4b07cd4a5091e0b |
| institution | Directory Open Access Journal |
| issn | 1973-4832 2283-3137 |
| language | English |
| last_indexed | 2024-12-11T12:23:52Z |
| publishDate | 2015-10-01 |
| publisher | SEEd |
| record_format | Article |
| series | Clinical Management Issues |
| spelling | doaj.art-e81c78d6ce8e46f9a4b07cd4a5091e0b2022-12-22T01:07:27ZengSEEdClinical Management Issues1973-48322283-31372015-10-0161S172210.7175/cmi.v6i1S.492454A case of ectopic ACTH secretionMonica Cevenini0Elena Guidetti1Maria Camilla Fabbri2Eleonora Galassi3Paola Tomassetti4Roberto Corinaldesi5Dipartimento di Medicina Clinica. Università degli Studi di Bologna, Ospedale Policlinico S. Orsola Malpighi, via Massarenti 9, 40138, Bologna, Italia
Dipartimento di Medicina Clinica. Università degli Studi di Bologna, Ospedale Policlinico S. Orsola Malpighi, via Massarenti 9, 40138, Bologna, Italia
Dipartimento di Medicina Clinica. Università degli Studi di Bologna, Ospedale Policlinico S. Orsola Malpighi, via Massarenti 9, 40138, Bologna, Italia
Dipartimento di Medicina Clinica. Università degli Studi di Bologna, Ospedale Policlinico S. Orsola Malpighi, via Massarenti 9, 40138, Bologna, Italia
Dipartimento di Medicina Clinica. Università degli Studi di Bologna, Ospedale Policlinico S. Orsola Malpighi, via Massarenti 9, 40138, Bologna, Italia
Dipartimento di Medicina Clinica. Università degli Studi di Bologna, Ospedale Policlinico S. Orsola Malpighi, via Massarenti 9, 40138, Bologna, Italia
We report the case of a 48-year-old woman, with a rapidly progressing ACTH neuroendocrine tumour of the pancreas (PNET) and multiple liver metastases. The patient had previously suffered from a peptic ulcer which was responsive to PPI inhibitors and hypertension which was poorly controlled by therapy. Admitted to the hospital for severe asthenia and abdominal pain, she was diagnosed with poorly differentiated PNET with liver metastases, which were positive for synaptophysin, cytokeratin 7 and 9 and neuron specific enolase (NSE). Octreoscan scintigraphy was positive for somatostatin receptors in the pancreas and in two liver lesions. A rapidly progressive Cushing’s syndrome developed, presenting with the classical physical symptoms, hypokalemia and Lysteria monocytogenes meningitis. Ectopic ACTH production was confirmed and eventually the patient died from a septic shock within two months. The case reported focuses on the malignity and the rapid progression of an ACTH-producing PNET and calls attention to the possible fatal progression of these cases.https://journals.seedmedicalpublishers.com/index.php/cmi/article/view/492Ectopic adrenocorticotropic hormone syndromeCushing’s syndromeNETsPancreatic neuroendocrine tumours |
| spellingShingle | Monica Cevenini Elena Guidetti Maria Camilla Fabbri Eleonora Galassi Paola Tomassetti Roberto Corinaldesi A case of ectopic ACTH secretion Clinical Management Issues Ectopic adrenocorticotropic hormone syndrome Cushing’s syndrome NETs Pancreatic neuroendocrine tumours |
| title | A case of ectopic ACTH secretion |
| title_full | A case of ectopic ACTH secretion |
| title_fullStr | A case of ectopic ACTH secretion |
| title_full_unstemmed | A case of ectopic ACTH secretion |
| title_short | A case of ectopic ACTH secretion |
| title_sort | case of ectopic acth secretion |
| topic | Ectopic adrenocorticotropic hormone syndrome Cushing’s syndrome NETs Pancreatic neuroendocrine tumours |
| url | https://journals.seedmedicalpublishers.com/index.php/cmi/article/view/492 |
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