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Endocrine Abstracts (2016) 41 EP90 | DOI: 10.1530/endoabs.41.EP90

1Department of Endocrinology, School of Medicine, Kirikkale University, Kirikkale, Turkey; 2Department of Internal Medicine, School of Medicine, Kirikkale University, Kirikkale, Turkey; 3Department of Pathology, School of Medicine, Ankara University, Ankara, Turkey; 4Department of Oncology, School of Medicine, Kirikkale University, Kirikkale, Turkey.

Background and aim: Pheochromocytoma, is a catecholamine-producing tumor, may rarely secrete other hormones such as adrenocorticotropic hormone (ACTH). We aimed to report a rare case of ectopic cushing syndrome due to malignant pheochromocytoma.

Case report: A 42-year-old man admitted to outpatient clinic with headache, irritability, vomiting, nausea, and palpitation. He had paroxysmal hypertension and urinary fractionated metanephrines were measured approximately 30 times higher than the upper limit of normal, during the hypertension attack. Abdominal computed tomography showed 43×62×78 mm mass lesion in the right adrenal gland and lymphadenopathy in the right para-aortic area. Endocrinological examinations demonstrated ectopic ACTH production and hypercortisolemia without overt symptoms of Cushing’s syndrome. He was operated for right adrenal mass following appropriate medical preparation. Postoperative pathology revealed that malignant,metastatic pheochromocytoma. Immunohistochemistry was performed and revealed that positive staining for ACTH.

Conclusions: Patients with pheochromocytoma also should have tests to exclude excess cortisol secretion. It must not be forgotten that most pheochromocytoma causes hypercortisolemia due to secreting ectopic ACTH.

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