Cushing’s syndrome associated with typical, peripheral pulmonary carcinoid tumor and N2 lymph node metastasis: case report

Background: The bronchopulmonary carcinoid tumor accounts for 1-2% of all adult malignancies of the lung and 20-30% of all carcinoid tumors. Cushing’s syndrome is the result of chronic exposure to increased concentration of exogenous or endo-genus cortisol hormone, and it is generally associated wit...

Full description

Bibliographic Details
Main Author: Reza Ershadi
Format: Article
Language:fas
Published: Tehran University of Medical Sciences 2020-07-01
Series:Tehran University Medical Journal
Subjects:
Online Access:http://tumj.tums.ac.ir/article-1-10604-en.html
id doaj-93ffc35ffd5241e1853999ac8e0f72c9
record_format Article
spelling doaj-93ffc35ffd5241e1853999ac8e0f72c92020-11-25T03:56:59ZfasTehran University of Medical SciencesTehran University Medical Journal1683-17641735-73222020-07-01785333336Cushing’s syndrome associated with typical, peripheral pulmonary carcinoid tumor and N2 lymph node metastasis: case reportReza Ershadi0 Department of Thoracic Surgery, Vali-e-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Background: The bronchopulmonary carcinoid tumor accounts for 1-2% of all adult malignancies of the lung and 20-30% of all carcinoid tumors. Cushing’s syndrome is the result of chronic exposure to increased concentration of exogenous or endo-genus cortisol hormone, and it is generally associated with central obesity, metabolic syndrome, and hypertension. Treatment is based on decreasing cortisol levels in the blood, through medical or surgical approaches. Surgery is considered the main treatment for ectopic ACTH-secreting tumors. Paraneoplastic Cushing’s syndrome due to bronchopulmonary carcinoid tumor is a rare clinical occurrence, which has been reported in only a few case reports and case series. An average of 71% of typical carcinoid tumors were found to be central. 79% of patients with a peripheral carcinoid tumor and evidence of mediastinal node enlargement are likely to have an atypical carcinoid. Case Presentation: A 45 Years old male with a history of ectopic Cushing’s syndrome over the last two years was admitted to our department (Department of thoracic surgery, Teahran, Iran). He had a positive Octreotide scan of the hilar lymph nodes of the left lung at last evaluations. During the surgery, in the left lower lobe was resected (because a small nodule with tumoral appearance was seen in left lower lobe) with hilar and mediastinal lymph node dissection. Pathology indicated a typical carcinoid tumor with mediastinal lymph node metastasis. Plasma cortisol and ACTH were normalized following the surgery. Conclusion: The present study reported a rare case of Cushing paraneoplastic syndrome with typical bronchopulmonary carcinoid tumor and N2 lymph node metastasis. The high prevalence of lymph node involvement confirms the aggressive nature of these tumors and warrants complete anatomic resection with radical lymphadenectomy.http://tumj.tums.ac.ir/article-1-10604-en.htmlcarcinoid tumorcushing’s syndromemediastinum.
collection DOAJ
language fas
format Article
sources DOAJ
author Reza Ershadi
spellingShingle Reza Ershadi
Cushing’s syndrome associated with typical, peripheral pulmonary carcinoid tumor and N2 lymph node metastasis: case report
Tehran University Medical Journal
carcinoid tumor
cushing’s syndrome
mediastinum.
author_facet Reza Ershadi
author_sort Reza Ershadi
title Cushing’s syndrome associated with typical, peripheral pulmonary carcinoid tumor and N2 lymph node metastasis: case report
title_short Cushing’s syndrome associated with typical, peripheral pulmonary carcinoid tumor and N2 lymph node metastasis: case report
title_full Cushing’s syndrome associated with typical, peripheral pulmonary carcinoid tumor and N2 lymph node metastasis: case report
title_fullStr Cushing’s syndrome associated with typical, peripheral pulmonary carcinoid tumor and N2 lymph node metastasis: case report
title_full_unstemmed Cushing’s syndrome associated with typical, peripheral pulmonary carcinoid tumor and N2 lymph node metastasis: case report
title_sort cushing’s syndrome associated with typical, peripheral pulmonary carcinoid tumor and n2 lymph node metastasis: case report
publisher Tehran University of Medical Sciences
series Tehran University Medical Journal
issn 1683-1764
1735-7322
publishDate 2020-07-01
description Background: The bronchopulmonary carcinoid tumor accounts for 1-2% of all adult malignancies of the lung and 20-30% of all carcinoid tumors. Cushing’s syndrome is the result of chronic exposure to increased concentration of exogenous or endo-genus cortisol hormone, and it is generally associated with central obesity, metabolic syndrome, and hypertension. Treatment is based on decreasing cortisol levels in the blood, through medical or surgical approaches. Surgery is considered the main treatment for ectopic ACTH-secreting tumors. Paraneoplastic Cushing’s syndrome due to bronchopulmonary carcinoid tumor is a rare clinical occurrence, which has been reported in only a few case reports and case series. An average of 71% of typical carcinoid tumors were found to be central. 79% of patients with a peripheral carcinoid tumor and evidence of mediastinal node enlargement are likely to have an atypical carcinoid. Case Presentation: A 45 Years old male with a history of ectopic Cushing’s syndrome over the last two years was admitted to our department (Department of thoracic surgery, Teahran, Iran). He had a positive Octreotide scan of the hilar lymph nodes of the left lung at last evaluations. During the surgery, in the left lower lobe was resected (because a small nodule with tumoral appearance was seen in left lower lobe) with hilar and mediastinal lymph node dissection. Pathology indicated a typical carcinoid tumor with mediastinal lymph node metastasis. Plasma cortisol and ACTH were normalized following the surgery. Conclusion: The present study reported a rare case of Cushing paraneoplastic syndrome with typical bronchopulmonary carcinoid tumor and N2 lymph node metastasis. The high prevalence of lymph node involvement confirms the aggressive nature of these tumors and warrants complete anatomic resection with radical lymphadenectomy.
topic carcinoid tumor
cushing’s syndrome
mediastinum.
url http://tumj.tums.ac.ir/article-1-10604-en.html
work_keys_str_mv AT rezaershadi cushingssyndromeassociatedwithtypicalperipheralpulmonarycarcinoidtumorandn2lymphnodemetastasiscasereport
_version_ 1724462527042027520