Atypical Cushing's syndrome caused by ectopic ACTH secretion of an oesophageal adenocarcinoma

作者：Baas J M^*; Kapiteijn E; Pereira A M; Nortier J W R

来源：Netherlands Journal of Medicine, 2010, 68(6): 265-267.

• Cushing's syndrome
• ectopic ACTH secretion
• oesophagus carcinoma

We 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.

• 出版日期2010-6