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Endocrine Abstracts (2023) 90 EP893 | DOI: 10.1530/endoabs.90.EP893

1Istanbul Medipol University, Endocrinology, Istanbul, Turkey; 2Istanbul Medipol University, Internal Medicine, Istanbul, Turkey


Cushing’s syndrome as a result of ectopic adrenocorticotropic hormone (ACTH) secretion, is associated with various tumors. Lung squamous cell carcinoma (LUSC) causing ectopic ACTH syndrome is a very rare condition. A 70-year-old male patient with a history of LUSC was admitted to our clinic for evaluation of worsening delirium and hypokalemia. Two courses of pembrolizumab were administered to our patient who was diagnosed with LUSC a month ago. At presentation, neurological examination revealed disorientation, agitation and visual hallucinations. There were no signs of a Cushingoid appearance. Laboratory assessment showed a serum potassium of 2.8 mmol/l (3.1-5.5), glucose of 120 mg/dl (70-100), basal plasma cortisol of 39,3 µg/dl (6-18), ACTH 92,1 pg/mL (7,2-63,3) and post-1 mg dexamethasone serum cortisol 40,9 µg/dl. A high dose dexamethasone (8 mg) suppression test did not result in suppression of the cortisol levels (64,8µg/dl). Brain MRI was taken and no abnormality was detected in the pituitary gland. The patient’s adrenal glands were evaluated as normal in the abdominal imaging. According to the results, the patient was diagnosed with ectopic ACTH syndrome. Metyrapone treatment was started to block cortisol secretion.

Keywords: Ectopic ACTH syndrome, squamous cell lung cancer, delirium

Volume 90

25th European Congress of Endocrinology

Istanbul, Turkey
13 May 2023 - 16 May 2023

European Society of Endocrinology 

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