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Case report A 43-year-old male patient was seen with clinical signs consistent with Cushing's syndrome and adrenocorticotropic hormone-dependent hypercortisolemia. Despite a suspicious lesion on pituitary MRI, the high-dose dexamethasone suppression test and bilateral inferior petrosal sinus sampling findings were not compatible with Cushing's disease. In the thorax CT of the patient, who had also experienced COVID-19 infection, no tumor-like opacities were found, but no tumor lesion was identified, but no tumoral lesion was found. A multidisciplinary committee recommended a drug therapy program for hypercortisolemia, a cocktail of somatostatin analogs, and capecitabine plus temozolomide after a multidisciplinary committee approved hypercortisolemia. Result The conclusion This is a difficult case of UPO NEN presenting with ECS and confounding factors, such as prior infection and incidental lesions, during the diagnosis process. Even though radiologically undetectable, the case in question revealed the fact that a typical pulmonary carcinoid with a low proliferation index could lead to visible metastases even when radiologically undetectable.
Source link: https://doi.org/10.1007/s42000-021-00316-z
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