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- W2911712363 abstract "A 54 years old man was admitted to our hospital due to progressive signs and symptoms of Cushing syndrome. Once a biochemical diagnosis of Adrenocorticotropic Hormone (ACTH)-dependent hypercortisolism was established, high dose 8 mg overnight Dexamethasone Suppression Test (HDDST), 1-deamino-8-D-arginine vasopressin (DDAVP) stimulation test and a Magnetic Resonance Imaging (MRI) led to conflicting results and an ectopic ACTH syndrome was diagnosed following a Bilateral Inferior Petrosal Sinus Sampling (BIPPS). The localization of the source of ectopic ACTH secretion turned out to be a challenging task because most of imaging exams gave a negative result. After a prolonged follow-up, a chest Computed Tomography (CT) scan gave a morphological confirmation of a small focus in the right lung previously detected by a 68 Gallium-DOTATOC- Positron Emission Tomography (PET). A right lower lobectomy of the lung was performed and an ACTH-positive typical pulmonary carcinoid was diagnosed. Before surgery, a good management of hypercortisolism was obtained with somatostatin analog lanreotide for years, and only after a likely escape phenomenon was successfully prescribedoff-labelpasireotide. In this patient with occult ectopic ACTH syndrome (EAS), a watchful waiting approach, based on imaging re-evaluation,representeda valuable option, provided that a good management of hypercortisolism and its end-organ complications wasobtained" @default.
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- W2911712363 date "2018-12-18" @default.
- W2911712363 modified "2023-09-24" @default.
- W2911712363 title "Non Obvious Diagnosis of an Occult ACTH Dependent Cushing Syndrome" @default.
- W2911712363 doi "https://doi.org/10.6092/1828-6550/apmb.106.2.2018.a2" @default.
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