Endocrinology, Diabetes, and Metabolism Commons^™

Ectopic Acth Syndrome Due To Men-I Associated Metastatic Neuroendocrine Pancreatic Gastrinoma In A 22 Year Old Female Without Hyperparathyroidism: Diagnostic And Therapeutic Challenges, Vasudev Magaji, Mansoor Tanwir, Mary Korytkowski, Sue Challinor

Vasudev G Magaji MD, MS

Introduction: Ectopic ACTH production due to malignant tumors is a rare cause of Cushing's syndrome (CS). Diagnosis and treatment of such patients can be challenging. Case: 22 year old female with recent onset fatigue, weight gain, polyuria, polydipsia, presented with melena and hypotension. She had cushingoid facies, acne, central obesity, muscle weakness and purple striae. Labs showed: Cortisol 56 µg/dl (5-15), 24 hour UFC >1000 µg/24hr (5-50), Cortisol after 1mg Dexamethasone suppression 54 µg/dl (Learning points: When evaluating patients with suspected ectopic ACTH production, independent review of radiologic imaging should be done to avoid being misled by prior reports. EUS …