ACTH-Producing Neuroendocrine Carcinoma of the Liver with Cushing's Syndrome

Mudassar Sandozi; Saagar Pamulapati; Aniqa Zaidi; Zuzanna Stuart; Sneha Pamulapati; Ajay Doniparthi

doi:10.1155/2023/9946271

ACTH-Producing Neuroendocrine Carcinoma of the Liver with Cushing's Syndrome

Case Rep Oncol Med. 2023 Sep 26:2023:9946271. doi: 10.1155/2023/9946271. eCollection 2023.

Authors

Mudassar Sandozi¹, Saagar Pamulapati¹, Aniqa Zaidi¹, Zuzanna Stuart¹, Sneha Pamulapati², Ajay Doniparthi³

Affiliations

¹ Javon Bea Hospital-Rockton, Rockford, IL, USA.
² Midwestern University, Downers Grove, IL, USA.
³ University of South Florida, Tampa, IL, USA.

Abstract

Paraneoplastic Cushing's syndrome arises when neuroendocrine tumors cause excess glucocorticoid production. We report a case of ectopic ACTH-producing liver neuroendocrine tumor. A 71 y.o. female with a history of rectal squamous carcinoma presented with fatigue and diffuse swelling. Liver biopsy revealed metastatic neuroendocrine carcinoma. Workup revealed markedly elevated morning cortisol and ACTH. Overnight dexamethasone suppression testing and positive immunostaining for ACTH on biopsy suggested paraneoplastic Cushing's syndrome secondary to neuroendocrine hepatic tumors with bony metastasis. This explained the patient's persistent anasarca, hyperglycemia, and electrolyte abnormalities. Despite multiple interventions, the patient's clinical status declined, and she expired.

Publication types

Case Reports