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- Title
Imaging in covert ectopic ACTH secretion: a CT pictorial review.
- Authors
Sookur PA; Sahdev A; Rockall AG; Isidori AM; Monson JP; Grossman AB; Reznek RH; Sookur, Paul A; Sahdev, Anju; Rockall, Andrea G; Isidori, Andrea M; Monson, John P; Grossman, Ashley B; Reznek, Rodney H
- Abstract
The syndrome of ectopic adrenocorticotrophin secretion (EAS) is rare and is due to excess adrenocorticotrophin (ACTH) production from a nonpituitary tumour. These tumours can be covert, where the tumours are not readily apparent, and very small making them challenging to image. It is clinically and biochemically difficult to distinguish between covert EAS and Cushing's disease. The first-line investigation in locating the source of ACTH production is computed tomography (CT). The aim of this pictorial review is to illustrate the likely covert sites and related imaging findings. We review the CT appearances of tumours resulting in covert EAS and the associated literature. The most common tumours were bronchial carcinoid tumours, which appear as small, well-defined, round or ovoid pulmonary lesions. Rarer causes included thymic carcinoids, gastrointestinal carcinoids and pancreatic neuroendocrine tumours. Awareness of the imaging characteristics will aid identification of the source of ACTH production and allow potentially curative surgical resection.
- Publication
European Radiology, 2009, Vol 19, Issue 5, p1069
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-008-1274-5