Open AccessACTH‐producing thymic neuroendocrine tumor initially presenting as psychosis: A case report and literature review
Author(s) -
Okumura Taiki,
Takayama Shohei,
Nishio Shinichi,
Miyakoshi Takahiro,
Noguchi Takuro,
Kobayashi Takashi,
Fukushima Toshirou,
Sekiguchi Nodoka,
Otsuki Toshiaki,
Komatsu Mitsuhisa,
Koizumi Tomonobu
Publication year - 2019
Publication title -
thoracic cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 28
eISSN - 1759-7714
pISSN - 1759-7706
DOI - 10.1111/1759-7714.13099
Subject(s) - medicine , hypokalemia , psychosis , metyrapone , pathology , endocrinology , radiology , psychiatry
A 32‐year‐old woman was referred to our hospital because of severe psychosis and was found to have an ectopic ACTH‐producing thymic neuroendocrine tumor. Laboratory data revealed an elevated serum cortisol and plasma ACTH level, hypokalemia, and metabolic alkalosis. Chest computed tomography (CT) revealed an anterior mediastinal mass and multiple pulmonary nodules. As the patient was unable to communicate because of her consciousness disturbance, she was managed with artificial ventilation and deep sedation. Metyrapone and potassium supplementation were administered, and steroid psychosis gradually improved. Thoracic surgery was performed and the histopathological diagnosis was thymic neuroendocrine tumor with positive anti‐ACTH immunohistochemical staining. Here we present details of the case and review the literature.