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Diagnostic and therapeutic challenges in ectopic Cushing's syndrome without detectable tumour focus -- a case report.

Title: Diagnostic and therapeutic challenges in ectopic Cushing's syndrome without detectable tumour focus -- a case report.
Authors: Sas, Karolina Patrycja; Tokarczyk, Kamila; Zieliński, Damian; Strzelczyk, Janusz
Source: Journal of Pre-Clinical & Clinical Research; 2026, Vol. 20 Issue 1, p16-20, 5p
Subject Terms: Cushing's syndrome; Adrenocorticotropic hormone; Follow-up studies (Medicine); Differential diagnosis; Steroid drugs; Enzyme inhibitors; Tumor diagnosis
Abstract: Ectopic adrenocorticotropin (ACTH) secretion is a rare cause of Cushing's syndrome, often posing a diagnostic challenge, particularly when the source of excessive ACTH secretion cannot be localized. The case is presented of a 70-year-old woman with Cushing's syndrome caused by ectopic ACTH secretion from an elusive location. Despite extensive imaging (CT, MRI, PET/CT with 68Ga-DOTATATE), no tumour site could be identified. Metyrapone led to normalization of cortisol and ACTH levels and a two-year remission. After a recurrence of hypercortisolaemia, osilodrostat therapy was initiated, achieving renewed hormonal and clinical stabilization. This case highlights the importance of pharmacotherapy with steroidogenesis inhibitors as an effective alternative to surgery in patients with an unlocalized source of ectopic ACTH secretion, and the need for long-term endocrine follow-up. [ABSTRACT FROM AUTHOR]
: Copyright of Journal of Pre-Clinical & Clinical Research is the property of Witold Chodzki Institute of Rural Medicine and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Complementary Index