A rare case of Cushing syndrome ectopic-ACTH: A case report

Malignant tumors, nevertheless, have been associated with extremely high circulating ACTH and cortisol levels, short duration of symptoms Cushing syndrome (CS) besides atypical clinical phenotype, when compared pituitary-dependent Cushing. A 33-year-old woman a history insulin-induced diabetes admitted to our department for suspicion ACTH-dependent Cushing's held in front : clinic, biological syndrome, CLU 2894ug/24h, minute braking negative, cortisolemia 32.1ug/dl, 232ng/l, CT scan the adrenal glands favor moderate hyperplasia. MRI Pituitary without anomaly, strong negative braking. An Octreoscan objectified presence two thyroid nodules hypodense generation moderately fixing radiotracer, measuring respectively 1.9*1.2cm on right 1.5*1.1cm left. The focus intensely fixes retrotracheal radiotracer paravertebral retrotracer. Tumor markers are negative. patient was operated anopathy nodular dystrophy, reactive lymphadenitis, review iminohistochemistry is requested results progress. comes training 1 month post-operative, reports regular cycle return, examination shows disappearance purple stretch marks bruises. Control octreoscan absence signs neuroendocrine tumor at pleuro-pulmonary, digestive or level. nodule resected objective anti-ACTH antibodies immunohistochemistry. . Identification source can be challenging, as sometimes primary lesion not identified even after prolonged repeated follow-up.