{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:59:08Z","timestamp":1747184348091,"version":"3.40.5"},"reference-count":10,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T00:00:00Z","timestamp":1597708800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>Adrenocorticotropic hormone (ACTH)\u2010producing neuroendocrine neoplasm (NEN) of the thymus is rare. Lymph nodes and bones are the most common metastatic sites. Most cases present with florid Cushing's syndrome (CS). Here, we reported a 58\u2010year\u2010old woman, who presented with intermittent flush and weight loss. Imaging studies revealed tumors in the mediastinum, pancreas, and bones. Contrast\u2010enhanced harmonic endoscopic ultrasound (EUS) of the pancreatic tumors showed heterogeneous and hyperenhancing characteristics. EUS elastography revealed a heterogeneous stiff pattern. EUS\u2010fine needle biopsy to the pancreatic lesion confirmed the NEN nature. Serum ACTH and cortisol levels were abnormally high. Immunohistochemical staining of the thymic and pancreatic specimens was positive for ACTH. However, the patient did not have obvious CS appearance. The patient underwent surgery, radiation, EUS\u2010guided ethanol injection, and anti\u2010cancer medications, but the disease still progressed. The patient died from infection 16\u00a0months after NEN was diagnosed. In conclusion, the pancreas can be a metastatic site for ACTH\u2010producing thymic NEN. EUS\u2010associated procedures can help in the diagnosis and treatment of pancreatic metastatic NEN.<\/jats:p>","DOI":"10.1111\/den.13752","type":"journal-article","created":{"date-parts":[[2020,5,28]],"date-time":"2020-05-28T05:37:18Z","timestamp":1590644238000},"page":"458-463","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Endoscopic ultrasound ablation in a patient with multiple metastatic pancreatic tumors from adrenocorticotropic hormone\u2010producing thymic neuroendocrine neoplasm"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6112-2322","authenticated-orcid":false,"given":"Ling\u2010Kai","family":"Chang","sequence":"first","affiliation":[{"name":"Departments of Internal Medicine National Taiwan University Hospital Taipei 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