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ACTH Salglayan Broniyal Karsinoidin Neden Olduu Ektopik Cushing Sendromu Olgusu [Respir Case Rep]
Respir Case Rep. 2018; 7(2): 106-109 | DOI: 10.5505/respircase.2018.60024

ACTH Salglayan Broniyal Karsinoidin Neden Olduu Ektopik Cushing Sendromu Olgusu

Burin elik1, Uur Avc2, Ayegl Atmaca2
1Ondokuz Mays niversitesi Tp Fakltesi, Gs Cerrahisi Ad, Samsun
2Ondokuz Mays niversitesi Tp Fakltesi, Endokrinoloji Ad, Samsun

Kk hcreli akcier kanseri ve bronkopulmoner karsinoid tmrler ektopik ACTH salnmnn en sk nedenidir ve olduka nadir bir durumdur. Bu makalede ACTH salglayan broniyal karsinoid tmrnn neden olduu ektopik Cushing sendromlu olguyu sunduk. Bilin bulankl ve konuamama ikayetleri acil servise bavuran 65 yanda kadn hastada hipoglisemi, hipopotasemi, hiperkortizolemi ve ACTH ykseklii saptand. Hastann hipofiz ve batn MR'da patoloji saptanmad. Hastada hipofizer MR'n normal olmas ve bilateral inferior petrozal sins rneklemesinde santral/periferik ACTH gradientinin 2'nin altnda olmas ektopik ACTH salnmn dndrd. Toraks BT'de sa st lob apikal segmentte 12x10 mm subplevral nodl izlendi, PET-BT grntlemede patolojik FDG tutulumu izlenmedi. Hastaya genel anestezi altnda VATS wedge rezeksiyon uyguland ve histolojik incelemede tipik bronial karsinoid tans kondu. Hasta postoperatif 5. gnnde haliyle ile taburcu edildi. Karsinoid tmre bal ektopik Cushing sendromlu olgularda 5 yllk sakalm %70 olarak bildirilmekle birlikte 60 ya st hastalarda prognozun daha kt olduu rapor edilmektedir. Cerrahi olarak kaynan ortadan kaldrabilmesi hastann tedavisindeki en nemli admdr.

Anahtar Kelimeler: akcier, Cushing sendromu, ektopik, karsinoid tumor

A Case of Ectopic Cushing Syndrome Caused by ACTH-Releasing Bronchial Carcinoid

Burin elik1, Uur Avc2, Ayegl Atmaca2
1Ondokuz Mayis University Medical School, Department Of Thoracic Surgery, Samsun, Turkey
2Ondokuz Mayis University Medical School, Department Of Endocronology, Samsun, Turkey

Small cell lung cancer and bronchopulmonary carcinoid tumors are the most common causes of an ectopic release of adrenocorticotropic hormone (ACTH) release. In this article, a patient with Cushing syndrome caused by an ACTH-releasing bronchial carcinoid tumor is presented. A 65-year-old female patient was admitted to the emergency service with the complaints of blurred consciousness and loss of speech, and was diagnosed with hypoglycemia, hypopotassemia, hypercortisolemia, and a high ACTH level. Magnetic resonance images (MRI) of the pituitary gland and the abdomen revealed no pathology. Since the pituitary MRI was normal, and her central/peripheral ACTH gradient was less than 2 in bilateral inferior petrosal sinus sampling, it was considered to be a case of ectopic ACTH release. A thorax computed tomography (CT) revealed a 12x10 mm subpleural nodule at the right upper lobe apical segment. Pathological fludeoxyglucose involvement was not observed in PETCT imaging. The patient underwent video-assisted thoracoscopic surgery wedge resection under general anesthesia and was diagnosed with typical bronchial carcinoid based on a histological study. She was discharged (in that condition) on the fifth postoperative day. Although the survival rate in patients with ectopic Cushing syndrome caused by carcinoid tumor has been reported to be 70%, the prognosis in patients over 60 is worse. The surgical elimination of the source is the most significant step in treatment.

Keywords: lung, Cushing syndrome, carcinoid tumor, ectopic

Burin elik, Uur Avc, Ayegl Atmaca. A Case of Ectopic Cushing Syndrome Caused by ACTH-Releasing Bronchial Carcinoid. Respir Case Rep. 2018; 7(2): 106-109

Sorumlu Yazar: Burin elik, Trkiye
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