Thymic Hyperplasia as a Source of Ectopic ACTH Production

摘要

A 26 year-old man with suspected Cushing's disease underwent transsphenoidal exploration of the pit- uitary without any evidence of microadenoma or hyperplasia. Progressive hypercortisolism necessitated bilateral adrenalectomy. Postoperatively, skin pigmentation gradually developed with a marked elevation of plasma ACTH levels, and CT scanning uncovered a thymic mass. Following removal of the thymic mass, skin pigmentation dis- appeared and plasma ACTH levels fell to normal.