An Ectopic ACTH Secreting Metastatic Parotid Tumour

A 60-year old woman presented with features of Cushing’s syndrome (CS) secondary to an ectopic adrenocorticotropic hormone (ACTH) secreting metastatic parotid tumour 3 years after excision of the original tumour. She subsequently developed fatal intestinal perforation and unfortunately died despite...

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Main Authors: Thomas Dacruz, Atul Kalhan, Majid Rashid, Kofi Obuobie
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Endocrinology
Online Access:http://dx.doi.org/10.1155/2016/4852907
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author Thomas Dacruz
Atul Kalhan
Majid Rashid
Kofi Obuobie
author_facet Thomas Dacruz
Atul Kalhan
Majid Rashid
Kofi Obuobie
author_sort Thomas Dacruz
collection DOAJ
description A 60-year old woman presented with features of Cushing’s syndrome (CS) secondary to an ectopic adrenocorticotropic hormone (ACTH) secreting metastatic parotid tumour 3 years after excision of the original tumour. She subsequently developed fatal intestinal perforation and unfortunately died despite best possible medical measures. Ectopic ACTH secretion accounts for 5–10% of all patients presenting with ACTH dependent hypercortisolism; small cell carcinoma of lung (SCLC) and neuroendocrine tumours (NET) account for the majority of such cases. Although there are 4 previous case reports of ectopic ACTH secreting salivary tumours in literature, to our knowledge this is the first published case report in which the CS developed after 3 years of what was deemed as a successful surgical excision of primary salivary tumour. Our patient initially had nonspecific symptoms which may have contributed to a delay in diagnosis. Perforation of sigmoid colon is a recognised though underdiagnosed complication associated with steroid therapy and hypercortisolism. This case demonstrates the challenges faced in diagnosis as well as management of patients with CS apart from the practical difficulties faced while trying to identify source of ectopic ACTH.
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spelling doaj-art-b504ebee152646f39cfaf655d67a73452025-08-20T02:23:31ZengWileyCase Reports in Endocrinology2090-65012090-651X2016-01-01201610.1155/2016/48529074852907An Ectopic ACTH Secreting Metastatic Parotid TumourThomas Dacruz0Atul Kalhan1Majid Rashid2Kofi Obuobie3University Hospital of Wales, Cardiff, UKDepartment of Diabetes & Endocrinology, Royal Glamorgan Hospital, Mid Glamorgan CF72 8XR, UKRoyal Gwent Hospital, Newport, UKRoyal Gwent Hospital, Newport, UKA 60-year old woman presented with features of Cushing’s syndrome (CS) secondary to an ectopic adrenocorticotropic hormone (ACTH) secreting metastatic parotid tumour 3 years after excision of the original tumour. She subsequently developed fatal intestinal perforation and unfortunately died despite best possible medical measures. Ectopic ACTH secretion accounts for 5–10% of all patients presenting with ACTH dependent hypercortisolism; small cell carcinoma of lung (SCLC) and neuroendocrine tumours (NET) account for the majority of such cases. Although there are 4 previous case reports of ectopic ACTH secreting salivary tumours in literature, to our knowledge this is the first published case report in which the CS developed after 3 years of what was deemed as a successful surgical excision of primary salivary tumour. Our patient initially had nonspecific symptoms which may have contributed to a delay in diagnosis. Perforation of sigmoid colon is a recognised though underdiagnosed complication associated with steroid therapy and hypercortisolism. This case demonstrates the challenges faced in diagnosis as well as management of patients with CS apart from the practical difficulties faced while trying to identify source of ectopic ACTH.http://dx.doi.org/10.1155/2016/4852907
spellingShingle Thomas Dacruz
Atul Kalhan
Majid Rashid
Kofi Obuobie
An Ectopic ACTH Secreting Metastatic Parotid Tumour
Case Reports in Endocrinology
title An Ectopic ACTH Secreting Metastatic Parotid Tumour
title_full An Ectopic ACTH Secreting Metastatic Parotid Tumour
title_fullStr An Ectopic ACTH Secreting Metastatic Parotid Tumour
title_full_unstemmed An Ectopic ACTH Secreting Metastatic Parotid Tumour
title_short An Ectopic ACTH Secreting Metastatic Parotid Tumour
title_sort ectopic acth secreting metastatic parotid tumour
url http://dx.doi.org/10.1155/2016/4852907
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