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Past Issue:
Volume 21, Number 2 • April 2008
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The ectopic adrenocorticotropic hormone syndrome in carcinoid tumors

Poorya Fazel, MD, Prasanthi Ganesa, MD, Robert G. Mennel, MD, and Ned A. Austin, MD

Ectopic production of adrenocorticotropic hormone by carcinoid tumors is relatively uncommon and may not be recognized by physicians. This report describes a woman who had Cushing syndrome from the ectopic secretion of adrenocorticotropic hormone by a carcinoid tumor. Her cause of death was a pneumonia that may have been secondary to her untreated hypercortisolism. There are three instructive elements of this case: 1) the recognition of Cushing syndrome, 2) the association of Cushing syndrome with low-grade (carcinoid tumors) as well as with high-grade (small cell carcinoma) neuroendocrine tumors, and 3) the need to treat the hypercortisolism as well as the tumor.