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- Aya Kawanishi, Ryuzo Deguchi, Ayano Ito, Takashi Ueda, Kota Tsuruya, Yoshitaka Arase, Yoshihiro Shirataki, Toshiki Kodama, Masashi Morimachi, and Tatehiro Kagawa.
- Department of Gastroenterology, Tokai University School of Medicine, Japan.
- Intern. Med. 2024 May 30.
AbstractA 55-year-old woman presented to her primary care physician with facial and lower leg edema. After being referred to our hospital because of hypothyroidism and hypokalemia on blood tests, she also had elevated adrenocorticotropic hormone (ACTH) and cortisol levels, but a dexamethasone suppression test showed no cortisol suppression. Ectopic ACTH syndrome due to pancreatic neuroendocrine carcinoma (PNEC) was suspected. endoscopic ultrasound-guided fine-needle aspiration was performed, and a histopathological examination of the obtained specimen revealed multiple liver metastases of the PNEC. Imaging after etoposide and cisplatin therapy showed cystic changes in the primary lesions and shrinkage of the liver metastases, and the ACTH levels were within the normal range.
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