A patient presents with hemoptysis and Cushingoid features with a lack of dexamethasone suppression. What could be the likely reason?
Ectopic ACTH production is predominantly caused by Occult carcinoid tumors, most frequently in the lung, but also in thymus or pancreas. About 25% of patients with Pulmonary Carcinoid tumors are asymptomatic at the time of discovery. In symptomatic patients of pulmonary carcinoids, the most common clinical findings are those associated with bronchial obstruction, such as persistent cough, hemoptysis, and recurrent or obstructive pneumonitis. Wheezing, chest pain, and dyspnea also maybe noted. Although uncommon, various endocrine or neuroendocrine syndromes can be initial clinical manifestations of either typical or atypical pulmonary carcinoid tumors. Only advanced small cell lung cancer can cause ectopic ACTH production.
Adrenal Hyperplasia
Adrenal Adenoma
Bronchial Adenoma
Bronchial Carcinoid
Cushing Syndrome