A Case of Pancreatic Neuroendocrine Tumor with Liver Metastases Demonstrating the Possibility of Enhanced ACTH Production by the SACI Test
Objective. ACTH-producing pancreatic NETs have a propensity to metastasize, and in patients with metastases, there is no established method yet to precisely determine if the excess ACTH is produced by the primary or the metastatic tumors. Localizing the source of production of ACTH in such cases is...
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Case Reports in Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2024/5923680 |
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| author | Hirozumi Mori Masashi Tamura Ryo Ogawa Yuta Kimata Sho Endo Katsutoshi Sekine Sayuri Kodama Hiromi Hisazumi Watanabe Kiyoshi Ookuma Masahiro Jinzaki |
| author_facet | Hirozumi Mori Masashi Tamura Ryo Ogawa Yuta Kimata Sho Endo Katsutoshi Sekine Sayuri Kodama Hiromi Hisazumi Watanabe Kiyoshi Ookuma Masahiro Jinzaki |
| author_sort | Hirozumi Mori |
| collection | DOAJ |
| description | Objective. ACTH-producing pancreatic NETs have a propensity to metastasize, and in patients with metastases, there is no established method yet to precisely determine if the excess ACTH is produced by the primary or the metastatic tumors. Localizing the source of production of ACTH in such cases is important for devising suitable treatment strategies and evaluating the benefit of local therapies from the viewpoint of control of Cushing’s syndrome. Methods. We performed the selective arterial calcium injection (SACI) test combined with selective portal and hepatic venous sampling in a 32-year-old female patient with ectopic ACTH-producing pancreatic NET and liver metastases. Results. The blood level of ACTH after Ca loading was significantly elevated only in the vessels thought to be directly feeding the pancreatic tumor, and Ca loading from any artery did not significantly increase ACTH concentrations in the hepatic veins compared to the main trunk of the portal vein. Conclusions. The present case demonstrates that there might be an ACTH-producing p-NET that responds to Ca loading. Further in vitro studies are required to validate this possibility. |
| format | Article |
| id | doaj-art-0d3593480353404da8aa58f14e5dbe40 |
| institution | Kabale University |
| issn | 2090-651X |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Endocrinology |
| spelling | doaj-art-0d3593480353404da8aa58f14e5dbe402025-02-03T05:54:34ZengWileyCase Reports in Endocrinology2090-651X2024-01-01202410.1155/2024/5923680A Case of Pancreatic Neuroendocrine Tumor with Liver Metastases Demonstrating the Possibility of Enhanced ACTH Production by the SACI TestHirozumi Mori0Masashi Tamura1Ryo Ogawa2Yuta Kimata3Sho Endo4Katsutoshi Sekine5Sayuri Kodama6Hiromi Hisazumi Watanabe7Kiyoshi Ookuma8Masahiro Jinzaki9Department of RadiologyDepartment of RadiologyDepartment of RadiologyDepartment of MedicineDepartment of MedicineDepartment of MedicineDepartment of RadiologyDepartment of RadiologyDepartment of RadiologyDepartment of RadiologyObjective. ACTH-producing pancreatic NETs have a propensity to metastasize, and in patients with metastases, there is no established method yet to precisely determine if the excess ACTH is produced by the primary or the metastatic tumors. Localizing the source of production of ACTH in such cases is important for devising suitable treatment strategies and evaluating the benefit of local therapies from the viewpoint of control of Cushing’s syndrome. Methods. We performed the selective arterial calcium injection (SACI) test combined with selective portal and hepatic venous sampling in a 32-year-old female patient with ectopic ACTH-producing pancreatic NET and liver metastases. Results. The blood level of ACTH after Ca loading was significantly elevated only in the vessels thought to be directly feeding the pancreatic tumor, and Ca loading from any artery did not significantly increase ACTH concentrations in the hepatic veins compared to the main trunk of the portal vein. Conclusions. The present case demonstrates that there might be an ACTH-producing p-NET that responds to Ca loading. Further in vitro studies are required to validate this possibility.http://dx.doi.org/10.1155/2024/5923680 |
| spellingShingle | Hirozumi Mori Masashi Tamura Ryo Ogawa Yuta Kimata Sho Endo Katsutoshi Sekine Sayuri Kodama Hiromi Hisazumi Watanabe Kiyoshi Ookuma Masahiro Jinzaki A Case of Pancreatic Neuroendocrine Tumor with Liver Metastases Demonstrating the Possibility of Enhanced ACTH Production by the SACI Test Case Reports in Endocrinology |
| title | A Case of Pancreatic Neuroendocrine Tumor with Liver Metastases Demonstrating the Possibility of Enhanced ACTH Production by the SACI Test |
| title_full | A Case of Pancreatic Neuroendocrine Tumor with Liver Metastases Demonstrating the Possibility of Enhanced ACTH Production by the SACI Test |
| title_fullStr | A Case of Pancreatic Neuroendocrine Tumor with Liver Metastases Demonstrating the Possibility of Enhanced ACTH Production by the SACI Test |
| title_full_unstemmed | A Case of Pancreatic Neuroendocrine Tumor with Liver Metastases Demonstrating the Possibility of Enhanced ACTH Production by the SACI Test |
| title_short | A Case of Pancreatic Neuroendocrine Tumor with Liver Metastases Demonstrating the Possibility of Enhanced ACTH Production by the SACI Test |
| title_sort | case of pancreatic neuroendocrine tumor with liver metastases demonstrating the possibility of enhanced acth production by the saci test |
| url | http://dx.doi.org/10.1155/2024/5923680 |
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