Introduction: Ectopic ACTH syndrome (EAS) occurs in about 5-10% of ACTH-dependent hypercortisolism and, in up to 15% of cases, is related to occult neoplasms.
Aim(s): We report one case of EAS highlighting the usefulness of Nuclear Medicine imaging in pre- and intraoperative localization of the ACTH-secreting neoplasm.
Materials and methods: A 66-year-old male patient was diagnosed in 2010 with ACTH-dependent hypercortisolism. Pituitary MRI was negative, while a chest-abdomen CT scan described a 7-mm nodule in the upper lobe of the right lung. Bilateral Inferior Petrosal Sinus Sampling (BIPSS) showed no evidence of center-periphery ACTH gradient. An Octreoscan did not reveal any area of pathological hyperuptake. Treatment with ketoconazole and lanreotide was started with clinical benefit. In July 2011, the patient underwent a PET/CT scan with 68Ga-DOTANOC that revealed mild hyperuptake of the lung nodule.
Conference: 9th Annual ENETS Conference (2012)
Presenting Author: Prof Laura De Marinis
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