ISSN ONLINE: 2558-815X
ISSN PRINT: 1584-9244
ISSN-L: 1584-9244

An ectopic ACTH-secreting tumour after adrenalectomy for primary aldosteronism


Introduction. Ectopic adrenocorticotropic hormone syndrome (EAS) is a rare cause of endogenous ACTH-dependent Cushing’s syndrome. EAS occurs in about 5–10% of all patients with ACTH-dependent hypercortisolism, with most of cases caused by intrathoracic neoplasms. Tumour detection is still a challenge and often requires multiple imaging procedures.
Case presentation. We describe a case of an ectopic ACTH secretion several months after left laparoscopic adrenalectomy for primary aldosteronism. A 21-year-old male patient presented with severe hypertension, hypokalemia as the first clinical manifestations of an ACTH-secreting lung neuroendocrine tumour, with the typical phenotypic features of Cushing’s syndrome. Six months before, the same patient underwent a right laparoscopic adrenalectomy for primary aldosteronism, confirmed by clinical, biochemical, radiological, and histopathological findings.
Conclusions. Neuroendocrine tumours are rare, difficult to diagnose and have a poor prognosis when associated with ectopic ACTH secreting Cushing syndrome.
Keywords: neuroendocrine tumours, Cushing’s syndrome, hyperaldosteronism, hypokalemia.

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Address for correspondence:
Ergita NELAJ
Department of Internal Medicine, University Hospital Center “Mother Teresa”, Tirana, Albania
Address: Dibra’s Street no 370, Tirana, Albania


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Nelaj E, Kecaj I, Feracaku J, Asqeri D, Gjata A, Gradica F, Ylli A, Tase M. An ectopic ACTH-secreting tumour after adrenalectomy for primary aldosteronism. Arch Balk Med Union. 2024;59(1):118-123.