Caspian Journal of Internal Medicine
Babol University of Medical Sciences
Sat, Sep 12, 2026
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Volume 17, Issue 3 (Summer 2026)
Caspian J Intern Med 2026, 17(3): 681-687 |
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Ruiz-Huaranga E G, Quinones Avila M D P, Marcilla Truyenque R L, Concepcion-Zavaleta M J, Paz-Ibarra J, Fuentes-Mendoza J et al . First case report of ectopic Cushing's syndrome secondary to synchronous mediastinal neuroendocrine tumors. Caspian J Intern Med 2026; 17 (3) :681-687
URL: http://caspjim.com/article-1-4832-en.html
URL: http://caspjim.com/article-1-4832-en.html
Edita Guadalupe Ruiz-Huaranga 
, Maria del Pilar Quinones Avila , Rosa Laurie Marcilla Truyenque , Marcio Jose Concepcion-Zavaleta * , Jose Paz-Ibarra , Jenyfer Fuentes-Mendoza , Juan Eduardo Quiroz-Aldave
, Maria del Pilar Quinones Avila , Rosa Laurie Marcilla Truyenque , Marcio Jose Concepcion-Zavaleta * , Jose Paz-Ibarra , Jenyfer Fuentes-Mendoza , Juan Eduardo Quiroz-Aldave
Universidad Científica del Sur, Lima, Peru , marcio_conc_zav@outlook.es
Abstract: (23 Views)
Background: Ectopic Cushing's syndrome (ECS) is a rare cause of hypercortisolism resulting from non-pituitary adrenocorticotropic hormone (ACTH) secretion, most associated with neuroendocrine tumors (NETs) of pulmonary or gastrointestinal origin. Mediastinal NETs are an extremely rare source.
Case Presentation: We report the case of a 23-year-old male with no relevant medical history, presenting with progressive muscle weakness, hyperpigmentation, weight gain, and signs of severe hypercortisolism, including moon facies, ecchymosis, hypertension, hyperglycemia, and hypokalemia. Hormonal tests confirmed ECS with markedly elevated ACTH and cortisol levels. Imaging revealed two anterior mediastinal masses. Histopathological analysis of the surgical specimens confirmed ACTH-producing atypical NETs.
Conclusions: This case highlights the importance of considering ectopic ACTH secretion from mediastinal neuroendocrine tumors in the differential diagnosis of severe, rapidly progressive hypercortisolism. Early recognition and timely surgical management can prevent life-threatening complications and improve patient outcomes, even in rare and aggressive presentations.
Case Presentation: We report the case of a 23-year-old male with no relevant medical history, presenting with progressive muscle weakness, hyperpigmentation, weight gain, and signs of severe hypercortisolism, including moon facies, ecchymosis, hypertension, hyperglycemia, and hypokalemia. Hormonal tests confirmed ECS with markedly elevated ACTH and cortisol levels. Imaging revealed two anterior mediastinal masses. Histopathological analysis of the surgical specimens confirmed ACTH-producing atypical NETs.
Conclusions: This case highlights the importance of considering ectopic ACTH secretion from mediastinal neuroendocrine tumors in the differential diagnosis of severe, rapidly progressive hypercortisolism. Early recognition and timely surgical management can prevent life-threatening complications and improve patient outcomes, even in rare and aggressive presentations.
Keywords: Ectopic ACTH Syndrome, Cushing Syndrome, Neuroendocrine Tumors, Mediastinal Neoplasms, Case Reports.
Policy Brief: case report |
Subject:
Endocrinology
Received: 2025/07/16 | Accepted: 2025/09/7 | Published: 2026/06/29
Received: 2025/07/16 | Accepted: 2025/09/7 | Published: 2026/06/29
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