Sandozi Mudassar, Pamulapati Saagar, Zaidi Aniqa, Stuart Zuzanna, Pamulapati Sneha, Doniparthi Ajay
Javon Bea Hospital-Rockton, Rockford, IL, USA.
Midwestern University, Downers Grove, IL, USA.
Case Rep Oncol Med. 2023 Sep 26;2023:9946271. doi: 10.1155/2023/9946271. eCollection 2023.
Paraneoplastic Cushing's syndrome arises when neuroendocrine tumors cause excess glucocorticoid production. We report a case of ectopic ACTH-producing liver neuroendocrine tumor. A 71 y.o. female with a history of rectal squamous carcinoma presented with fatigue and diffuse swelling. Liver biopsy revealed metastatic neuroendocrine carcinoma. Workup revealed markedly elevated morning cortisol and ACTH. Overnight dexamethasone suppression testing and positive immunostaining for ACTH on biopsy suggested paraneoplastic Cushing's syndrome secondary to neuroendocrine hepatic tumors with bony metastasis. This explained the patient's persistent anasarca, hyperglycemia, and electrolyte abnormalities. Despite multiple interventions, the patient's clinical status declined, and she expired.
副肿瘤性库欣综合征是由神经内分泌肿瘤导致糖皮质激素分泌过多引起的。我们报告一例异位分泌促肾上腺皮质激素（ACTH）的肝脏神经内分泌肿瘤病例。一名71岁女性，有直肠鳞癌病史，出现疲劳和全身弥漫性肿胀。肝脏活检显示为转移性神经内分泌癌。检查发现晨起皮质醇和ACTH水平显著升高。过夜地塞米松抑制试验及活检中ACTH免疫染色阳性提示继发于伴有骨转移的神经内分泌性肝肿瘤的副肿瘤性库欣综合征。这解释了患者持续的全身性水肿、高血糖和电解质异常。尽管进行了多种干预措施，患者的临床状况仍恶化，最终死亡。
