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...
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Tehran University of Medical Sciences
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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 |
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1724462527042027520 |