Successful use of 111In-pentetrotide scintigraphy for localizing ectopic adrenocorticotropin-producing bronchial carcinoid tumor in a patient with Cushing's syndrome

A 34-year-old man was diagnosed with clinical Cushing's syndrome based on circadian fluctuation of plasma adrenocorticotropin and serum cortisol levels and Liddle's-method. The presence of ectopic adrenocorticotropin production was suspected. Urine 5-hydroxyindoleaceturic acid level was high. Chest computedtomography scan revealed a mass in the right upper lung. In-111-pentetrotide scintigraphy demonstrated marked accumulation in the right upper lung. We suspected an adrenocorticotropin-producing bronchial carcinoid. Plasma adrenocorticotropin and serum cortisol levels decreased immediately following resection of the tumor. Adrenocorticotropin production by tumor cells was confirmed by immunohistochemistry. This case indicates In-111-pentetrotide scintigraphy could be successfully used to identify and localize ectopic adrenocorticotropin-producing bronchial carcinoid.