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Ann Geriatr Med Res > Volume 17(4); 2013 > Article
Journal of the Korean Geriatrics Society 2013;17(4):228-233.
DOI: https://doi.org/10.4235/jkgs.2013.17.4.228    Published online December 31, 2013.
Ectopic Adrenocorticotropic Hormone Syndrome Associated With Thymic Carcinoma in Old Age
Min Gyu Kim, Il Hwan Ryu, Joo Seok Kim, Su A Yoon, Jae Min Lee, Hye Min Yu, Kang Seo Park
Department of Internal Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea. leejam25@eulji.ac.kr
노인에서 발병한 흉선종에 의한 이소성
부신피질자극호르몬증후군 1예
을지대학교 의과대학 내과학교실
A 70-year-old woman who developed a moon face was hospitalized. At admission, adrenocorticotropic hormone (ACTH) and serum cortisol levels were elevated. A high-dose dexamethasone suppression test demonstrated that cortisol secretion was uninhibited. Furthermore, chest computed tomography revealed an anterior mediastinal mass. On the basis of these results, ectopic ACTH syndrome was diagnosed and complete resection of the thymic tumor was performed. Histological examination revealed large cell neuroendocrine carcinoma of the thymus and positive immunoreactivity for ACTH. However, despite complete excision of the thymic tumor, ACTH and serum cortisol levels were high. Therefore, we investigated whether the lesion had recurred or metastasized; however, the results were inconclusive. Finally, laparoscopic bilateral adrenalectomy was performed to control the hypercortisolemia. After the surgery, the serum cortisol level was well-controlled and the general condition of the patient was good.
Key Words: Ectopic ACTH syndrome, Thymic carcinoma, Neuroendocrine carcinoma
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