J M Baas, E Kapiteijn, A M Pereira, J W R Nortier
Department of Clinical Oncology, Leiden University Medical Centre, Leiden, the Netherlands. j.m.baas@lumc.nl
The Netherlands journal of medicine 2010 JunWe present an atypical case of Cushing's syndrome caused by ectopic adrenocorticotropic hormone (ACTH) secretion in a patient with a metastasised adenocarcinoma of the oesophagus. After chemotherapy and surgery the patient developed generalised oedema, hyperpigmentation and dysphagia. Laboratory tests showed hypokalaemia, normal urinary potassium, increased 24-hour urinary free cortisol excretion and serum ACTH within the normal reference range. The diagnosis of ACTH-dependent Cushing's syndrome was made, most probably caused by ectopic production of ACTH. In addition to combined chemotherapy, treatment with ketoconazole sufficiently reduced urinary cortisol excretion and relieved the symptoms.
J M Baas, E Kapiteijn, A M Pereira, J W R Nortier. Atypical Cushing's syndrome caused by ectopic ACTH secretion of an oesophageal adenocarcinoma. The Netherlands journal of medicine. 2010 Jun;68(6):265-7
PMID: 20558857
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