A Discrepancy Between Somatostatin Receptor Scintigraphy and Treatment Response of Somatostatin Analogs in a Case of Occult Adrenocorticotropic Syndrome

Abstract

Ectopic adrenocorticotropic (ACTH) syndrome is a relatively rare cause of Cushing's syndrome. Sometimes the tumor cannot be found. Unfortunately, medical treatment is sometimes ineffective and bilateral adrenalectomy becomes necessary. We report a case of Cushing's syndrome with the clinical and biochemical characteristics of ectopic ACTH syndrome, but the source of the ACTH could not be found. Somatostatin receptor scintigraphy was negative. Somatostatin analog was tried after a positive Sandostatin test. Cushing's syndrome improved. Six months later this treatment failed.