FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W3021094914> ?p ?o ?g. }

• W3021094914 abstract "Abstract Background: Ectopic ACTH syndrome accounts for about 14% of Cushing syndrome cases. Small cell lung cancer is the most common cause. A few case reports described ectopic ACTH syndrome in patients with parotid acinic cell carcinoma. Parotid carcinoma ex pleomorphic adenoma is a malignant transformation within a pleomorphic adenoma, which is mostly adenocarcinoma not otherwise specified, but other subtypes can occur. Clinical Case: A 41-year old man with parotid cancer and hypothyroidism was admitted to the hospital for hypokalemia (2.1 mmol/L, n: 3.5-5 mmol/L). Parotid cancer was diagnosed a year before admission. At that time, he underwent left parotidectomy, and pathology showed carcinoma ex pleomorphic adenoma with areas of acinic cell carcinoma. Despite chemoradiation, he was diagnosed with metastasis in the lungs, for which pembrolizumab was started. Over the two months prior to admission, he gained 20 lb, and developed lower extremity weakness, acne, erectile dysfunction and loss of libido. He was also diagnosed with hypertension and started to have mild hypokalemia. Suspecting hyperaldosteronism, oncology team ordered labs just prior to admission, which showed the hypokalemia of 2.1 mmol/L, hypernatremia (147 mmol/L, n: 133-143 mmol/L), normal aldosterone and renin, and high cortisol (59.12 mcg/dL, n: 3-22 mcg/dL) and ACTH (121 pg/mL, n: 9-50 pg/mL). In the hospital, potassium was slowly improving despite aggressive replacement, and blood pressure was still elevated despite increasing his lisinopril dose. Screening for Cushing syndrome revealed an abnormal 1 mg dexamethasone suppression test (cortisol 51.9 mcg/dL, n: &lt;1.8 mcg/dL), and high 24-hour urinary free cortisol (6495 mcg/24h, n: 3.5-45 mcg/24h) and midnight salivary cortisol (2610 ng/dL and 4250 ng/dL, n: &lt;100 ng/dL). Cortisol was not suppressed after 8 mg dexamethasone (cortisol 47.85 mcg/dL, pretest cortisol 48.73 mcg/dL) pointing toward ectopic ACTH syndrome. Spironolactone was started and titrated up to 100 mg BID with better control of hypertension and normalization of potassium. Ketoconazole was started at 200 mg TID and increased gradually as outpatient to 400 mg TID within three weeks. A repeat 24-hour urinary free cortisol was done five weeks after ketoconazole was started showing significant improvement (110 mcg/24h, n: 3.5-45 mcg/24h). Potassium requirements remarkably decreased from 80 mEq TID to 40 mEq daily. Of note, chest CT done during hospitalization showed new lung lesions despite treatment with pembrolizumab. Conclusion: This is the first case of ectopic ACTH syndrome to be described in a patient with parotid carcinoma ex pleomorphic adenoma, though areas of acinic cell carcinoma within the tumor can be the source of ACTH. Hypercortisolism due to ectopic ACTH secretion is usually of rapid onset, and can present with severe hypokalemia. Steroid synthesis inhibitors seem to be an effective therapy." @default.
• W3021094914 created "2020-05-13" @default.
• W3021094914 creator A5000690251 @default.
• W3021094914 creator A5029690872 @default.
• W3021094914 creator A5037724688 @default.
• W3021094914 date "2020-04-01" @default.
• W3021094914 modified "2023-09-23" @default.
• W3021094914 title "SAT-213 Parotid Carcinoma Ex Pleomorphic Adenoma Can Produce Ectopic ACTH Too" @default.
• W3021094914 doi "https://doi.org/10.1210/jendso/bvaa046.790" @default.
• W3021094914 hasPublicationYear "2020" @default.
• W3021094914 type Work @default.
• W3021094914 sameAs 3021094914 @default.
• W3021094914 citedByCount "0" @default.
• W3021094914 crossrefType "journal-article" @default.
• W3021094914 hasAuthorship W3021094914A5000690251 @default.
• W3021094914 hasAuthorship W3021094914A5029690872 @default.
• W3021094914 hasAuthorship W3021094914A5037724688 @default.
• W3021094914 hasBestOaLocation W30210949141 @default.
• W3021094914 hasConcept C126322002 @default.
• W3021094914 hasConcept C2777546739 @default.
• W3021094914 hasConcept C2778242168 @default.
• W3021094914 hasConcept C2778937882 @default.
• W3021094914 hasConcept C2780329156 @default.
• W3021094914 hasConcept C2780859518 @default.
• W3021094914 hasConcept C2780885620 @default.
• W3021094914 hasConcept C2781437628 @default.
• W3021094914 hasConcept C71924100 @default.
• W3021094914 hasConcept C90924648 @default.
• W3021094914 hasConceptScore W3021094914C126322002 @default.
• W3021094914 hasConceptScore W3021094914C2777546739 @default.
• W3021094914 hasConceptScore W3021094914C2778242168 @default.
• W3021094914 hasConceptScore W3021094914C2778937882 @default.
• W3021094914 hasConceptScore W3021094914C2780329156 @default.
• W3021094914 hasConceptScore W3021094914C2780859518 @default.
• W3021094914 hasConceptScore W3021094914C2780885620 @default.
• W3021094914 hasConceptScore W3021094914C2781437628 @default.
• W3021094914 hasConceptScore W3021094914C71924100 @default.
• W3021094914 hasConceptScore W3021094914C90924648 @default.
• W3021094914 hasLocation W30210949141 @default.
• W3021094914 hasLocation W30210949142 @default.
• W3021094914 hasOpenAccess W3021094914 @default.
• W3021094914 hasPrimaryLocation W30210949141 @default.
• W3021094914 hasRelatedWork W1789652 @default.
• W3021094914 hasRelatedWork W20565001 @default.
• W3021094914 hasRelatedWork W218178 @default.
• W3021094914 hasRelatedWork W22474374 @default.
• W3021094914 hasRelatedWork W2815209 @default.
• W3021094914 hasRelatedWork W4082110 @default.
• W3021094914 hasRelatedWork W4459791 @default.
• W3021094914 hasRelatedWork W5200233 @default.
• W3021094914 hasRelatedWork W19290910 @default.
• W3021094914 hasRelatedWork W20977764 @default.
• W3021094914 isParatext "false" @default.
• W3021094914 isRetracted "false" @default.
• W3021094914 magId "3021094914" @default.
• W3021094914 workType "article" @default.