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POSTGRADUATE CLINICAL SECTION
Year : 2012  |  Volume : 7  |  Issue : 1  |  Page : 42-43
Anterior mediastinal mass in a patient with Cushing's syndrome


1 Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Date of Submission18-Aug-2011
Date of Acceptance23-Sep-2011
Date of Web Publication6-Jan-2012

Correspondence Address:
Sameer Vyas
Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh
India
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DOI: 10.4103/1817-1737.91557

PMID: 22347350

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How to cite this article:
Vyas S, Gorsi U, Bansali A, Khandelwal N. Anterior mediastinal mass in a patient with Cushing's syndrome. Ann Thorac Med 2012;7:42-3

How to cite this URL:
Vyas S, Gorsi U, Bansali A, Khandelwal N. Anterior mediastinal mass in a patient with Cushing's syndrome. Ann Thorac Med [serial online] 2012 [cited 2014 Aug 30];7:42-3. Available from: http://www.thoracicmedicine.org/text.asp?2012/7/1/42/91557


A 35-year-old male patient presented with complaints of weight loss, facial puffiness, and pedal edema. On physical examination, he was found to be hypertensive (blood pressure - 180/110 mm Hg) and showed centripetal obesity, buffalo hump, and purple striae over body. On biochemical evaluation, patient was found to be diabetic. Fasting blood sugar was 155 mg/dl. He had elevated levels of serum cortisol with loss of circadian rhythm and elevated levels of adrenocorticotropic hormone (ACTH). 8 am cortisol levels were 51 μg/dl and plasma ACTH was 207 pg/ml. The mean plasma cortisol after dexamethasone suppression test (DST) showed non-suppressibility. Overnight DST was >1750 and low dose DST was 1209. Magnetic Resonance Imaging showed no pituitary adenoma. Chest radiograph [Figure 1] showed a well-defined lobulated mediastinal mass silhouetting right heart border. Contrast-enhanced computed tomographic (CT) [Figure 2] in mediastinal window showed a well-defined lobulated heterogeneously enhancing mass lesion in anterior mediastinum. No lung parenchymal lesion was evident.
Figure 1: Chest radiograph showing a well-defined lobulated mediastinal mass

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Figure 2: Contrast-enhanced CT showing a well-defined lobulated heterogeneously enhancing mass lesion in anterior mediastinum

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   Question Top


What is the Diagnosis?



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   References Top

1.Bhansali A, Walia R, Rana SS, Dutta P, Radotra BD, Khandelwal N, et al. Ectopic Cushing's syndrome: Experience from a tertiary care centre. Indian J Med Res 2009;129:33-41.  Back to cited text no. 1
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2.Elsayes KM, Menias CO, Bowerson M, Osman OM, Alkharouby AM, Hillen TJ. Imaging of carcinoid tumors: Spectrum of findings with pathologic and clinical correlation. J Comput Assist Tomogr 2011;35:72-80.  Back to cited text no. 2
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3.Ruffini E, Oliaro A, Novero D, Campisi P, Filosso PL. Neuroendocrine tumors of the thymus. Thorac Surg Clin 2011;21:13-23.  Back to cited text no. 3
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4.Van Brandt V, Heyman S, Van Marck E, Hendriks J, Van Schil P. Atypical presentation of an atypical carcinoid. Ann Thorac Surg 2009;88:2004-6.  Back to cited text no. 4
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5.Dutta R, Kumar A, Julka PK, Mathur SR, Kaushal S, Kumar R, et al. Thymic neuroendocrine tumour (carcinoid): Clinicopathological features of four patients with different presentation. Interact Cardiovasc Thorac Surg 2010;11:732-6.  Back to cited text no. 5
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