AB - We report a 42 years old male and a 66 years old female with a Cushing syndrome caused by ectopic ACTH secretion secondary to a carcinoid tumor. These patients had both severe hypokalemia, resistant to medical treatment and that subsided with bilateral adrenalectomy and supplementation with dexametasone. Cushing syndrome caused by ectopic ACTH secretion is characterized by a severe and rapidly evolving hypercortisolism. Therefore, this alteration will increase the mineralocorticoid action of cortisol. By contrast, prognosis of ECL-omas in patients with ZES or chronic atrophic gastritis is good.
Metastases are rare, and tumor-related deaths are exceptional.
In both conditions, ECL-omas measuring less than 1 cm should be treated by endoscopic polypectomy and survey. The impact of endoscopic ultrasonography on the therapeutic decision has not yet been evaluated. Considering the good prognosis of these tumors, aggressive surgery could be limited to selected patients.