A 62 year old man with a long smoking history presents with new onset diabetes, proximal muscle weakness, hypokalemic metabolic alkalosis, and diffuse hyperpigmentation. Cortisol is very high, ACTH is very high, and there is no suppression with high dose dexamethasone. Which of the following is the most likely source of excess ACTH?
- A)Pituitary microadenoma
- B)Thyroid medullary carcinoma
- C)Pheochromocytoma
- D)Adrenal adenoma
- E)Small cell carcinoma of the lungGABARITO
Explicação
This patient has ectopic ACTH syndrome, classically from small cell carcinoma of the lung. Marked ACTH elevation, lack of suppression with high dose dexamethasone, and severe metabolic derangements support an ectopic source rather than pituitary disease. Hyper... Ver explicação completa e trilha adaptativa →