F-18 FDG PET/CT imaging of endogenous cushing syndrome
Department of Radiology, Boston University School of Medicine, Boston, MA, USA. Clinical nuclear medicine
(Impact Factor: 3.93).
12/2011; 36(12):e231-2. DOI: 10.1097/RLU.0b013e3182336360
Cushing syndrome (CS) is a rare condition, with an incidence of 2 to 4 cases per million inhabitants per year. In most cases of CS, elevated adrenocorticotropic hormone (ACTH) secretion results in excess adrenal gland cortisol secretion but usually this is from pituitary, not ectopic ACTH production. We present a case of a 52-year-old woman with lower extremity edema and weakness. Physical examination revealed alopecia, hyperpigmentation, acne, and a 4-cm right thyroid mass with lymphadenopathy. Biopsy revealed medullary thyroid carcinoma (MTC). She was also diagnosed with CS caused by ectopic ACTH production, presumably from the MTC. PET/CT showed a large mass within the right lobe of the thyroid gland, extensive metastatic disease and bilateral adrenal gland hypertrophy due to CS which initially raised concern for adrenal metastases.
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