LOCALIZATION AND POSTOPERATIVE FOLLOW-UP OF A BRONCHIAL CARCINOID-TUMOR CAUSING CUSHINGS-SYNDROME BY IN-111-DTPA LABELED OCTREOTIDE SCINTIGRAPHY

Bronchial carcinoid tumor is the most frequent occult source of ectopi c ACTH-dependent Cushing's syndrome, but its initial localization may be very difficult, as well as its postoperative followup. We here pres ent the case of a 21-year-oId man with Cushing's syndrome and biochemi cal findings suggesting an ectopic source of ACTH (lack of inhibition of cortisol after overnight 8-mg dexamethasone supression test, and la ck of response to h-CRH challenge). Chest CT-scan showed a node adjace nt to the left lung hilium whose nature was confirmed by uptake of (11 1)Indium-DTPA labelled octreotide scintigraphy. Surgical resection of the tumor consisted in an upper lobectomy of the left lung. Microscopi c examination identified a typical carcinoid tumor. After surgery pitu itary-adrenal function normalized and a second scintigraphy offered ad ditional data on the absence of tumor remnants. (C) 1997, Editrice Kur tis.