68ga-dotanoc and Paranasal-Sinus-Neoplasms

Ectopic adrenocorticotropic hormone (ACTH)-secreting tumors account for approximately 10% of Cushing's syndrome (CS). We present an extremely rare case of a patient with CS caused by an ectopic ACTH-secreting pituitary adenoma (EAPA) of the ethmoid sinus. The tumor was identified by positron-emission tomography-computed tomography (PET/CT) using the somatostatin receptor analogue Ga-68-DOTANOC. Transnasal endoscopic resection was performed and the patient showed significant clinical improvement with normalization of the endocrine pituitary axis. Immunostaining showed a somatostatin receptor 2 and 5-positive ACTH-producing adenoma. In patients with ectopic ACTH secretion, Ga-68-DOTANOC-PET/CT may play an important role in the localization of EAPA. Transnasal endoscopic resection is the therapy of choice.

Topics: ACTH Syndrome, Ectopic; ACTH-Secreting Pituitary Adenoma; Adenoma; Adrenocorticotropic Hormone; Diagnosis, Differential; Gallium Radioisotopes; Humans; Male; Middle Aged; Multimodal Imaging; Organometallic Compounds; Paranasal Sinus Neoplasms; Positron-Emission Tomography; Tomography, X-Ray Computed