Diagnosis of ectopic adrenocorticotropic hormone (ACTH) and corticotropin-releasing hormone (CRH) co-secreting tumors causing Cushing syndrome (CS) is challenging because these tumors are rare and their diagnosis is frequently confused with Cushing disease (CD), caused by the effect of CRH on the pituitary. We report a case of a 21-year-old male patient who was referred to our institution with persistent hypercortisolemia and CS after undergoing unnecessary transsphenoidal surgery (TSS). 68Ga-DOTA-TATE PET/CT revealed increased tracer uptake in the thymus, which was histologically proven to be a neuroendocrine tumor (NET) that stained positive for ACTH and CRH. Imaging with 18F-FDG PET/CT was not diagnostic.
- F-FDG PET/CT
- Ga-DOTA-TATE PET/CT
- Cushing syndrome
- ectopic ACTH/CRH co-secreting tumors
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging