Cushing's like syndrome in typical bronchial carcinoid a case report and review of the literature

Abstract

Cushing's syndrome occurred in 1-5% of cases of bronchial carcinoids. In this paper we describe a case of typical bronchial carcinoid in a nonsmoker young male with clinical manifestations mimicking a Cushing's syndrome. The patient performed chest radiograph and computed tomography. Fiberoptic bronchoscopy revealed the presence of an endobronchial mass occluding the bronchus intermedius. A rigid bronchoscopy was necessary for the conclusive diagnosis and for partial resection of the intraluminal tumor. Despite of the presence of Cushingoid features, the normal blood levels of ACTH and cortisol excluded the coexistence of a Cushing's syndrome.

Keywords: Bronchial carcinoid; Bronchoscopy; Cushing’s syndrome.

Fig. 1

Chest radiograph showing a lift of right hemidiaphragm with ipsilateral scanty pleural effusion.

Fig. 2

Computed tomography: (a) presence of a solid mass in the bronchus intermedius; (b) atelectasis of middle and lower right lobe.

Fig. 3

Flexible bronchoscopy reveals a solid mass obliterating completely the bronchus intermedius.

Fig. 4

Flexible broncoscopy performed after partial resection of the neoplasm. In the figure are visible residual neoplastic tissue and the origins of the middle and lower bronchi.