Successful Use of ¹¹¹In-Pentetrotide Scintigraphy for Localizing Ectopic Adrenocorticotropin-Producing Bronchial Carcinoid Tumor in a Patient with Gushing's Syndrome

Abstract

A 34-year-old man was diagnosed with clinical Gushing's syndrome based on circadian fluctuation of plasma adrenocorticotropin and serum cortisol levels and Liddle's-method. The presence of ectopic adrenocorticotropin production was suspected. Urine 5-hydroxyindoleaceturic acid level was high. Chest computedtomography scan revealed a mass in the right upper lung. 111In-pentetrotide scintigraphy demonstrated marked accumulation in the right upper lung. We suspected an adrenocorticotropin-producing bronchial carcinoid. Plasma adrenocorticotropin and serum cortisol levels decreased immediately following resection of the tumor. Adrenocorticotropin production by tumor cells was confirmed by immunohistochemistry. This case indicates ¹¹¹In-pentetrotide scintigraphy could be successfully used to identify and localize ectopic adrenocorticotropinproducing bronchial carcinoid.
(Internal Medicine 42: 996-1005, 2003)