A case of adrenocorticotropic hormone-producing pancreatic neuroendocrine tumor presenting Cushing syndrome

A 77-year-old man with weight gain, whole body edema, and ptosis was referred to our hospital. Laboratory data shows hypokalemia, cortisol/adrenocorticotropic hormone (ACTH) elevation. Abdominal imaging revealed a mass at the pancreatic tail and multiple liver metastases. Since he was suffering from Cushing's symptoms, he received block and replace treatment after hospitalization to reduce cortisol level rapidly. EUS-FNA diagnosed ACTH-producing pancreatic NET G3. The patient's symptoms improved immediately following hormone therapy, and he was treated with combined sunitinib and lanreotide; however, the disease progression was extremely severe that he died because of the primary tumor.