A rare case of Ectopic Cushing's syndrome from a Benign Thymoma

Ectopic ACTH production leading to ectopic ACTH Syndrome (EAS) accounts for a small percentage of all Cushing's syndrome cases. Ectopic Adrenocorticotropic hormone (ACTH) secretion is primarily from small cell carcinoma and carcinoid of the lung, these two comprises half of cases ¹, others are mostly from tumors of the thymus, and the pancreas ² , therefore the majority of ectopic secretion cases originate from the lungs which make them the first place to be searched to find the ectopic spot. Here we present the case of a 30-year-old male who presented with complaints of generalized body swelling, increase in weight, facial puffiness, striae on both thigh. Clinical and laboratory findings were suggestive of Ectopic ACTH syndrome. CT scan of thorax revealed a soft tissue density lesion in anterior mediastinum suggestive of a benign thymoma. The main purpose is to present a case of ectopic Cushing’s syndrome and show how thorough investigation, early diagnosis and careful management are crucial to reduce morbidity and mortality.

Keywords: ACTH Syndrome, Ectopic Adrenocorticotropic hormone