Korean J Intern Med.
2000 Jul;15(2):142-146.
A case of Cushing's syndrome in ACTH-secreting mediastinal paraganglioma
- Affiliations
-
- 1Pulmonary Department of Internal Medicine, Chonnam University Medical School, Kwangju, Korea.
Abstract
- Paragangliomas are unusual neuroendocrine cell tumors arising from paraganglia,
of which ACTH-secreting cases in the mediastinum are extremely rare. A
51-year-old woman was admitted for generalized edema and weakness which began 5
months ago. Chest X-ray and CT scan revealed a tumor mass in the anterior
mediastinum. The plasma cortisol and ACTH levels were very high. Other sources
secreting ACTH, except mediastinal mass, were not found. Surgical excision of
mediastinal mass and left supraclavicular lymph node was performed. The
postoperative microscopic finding and immunohistochemical staining revealed
organoid tumor cell nests (zellballen) and S-100 protein positive sustentacular
cells which are characteristics of paraganglioma. This was thus a case of
Cushing's syndrome resulting from ectopic ACTH production in anterior
mediastinal paraganglioma.