{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:15:53Z","timestamp":1781741753032,"version":"3.54.5"},"reference-count":9,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,4,8]]},"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:p>In this case report, we present a case of a woman in her late 30s who presented with bilateral motor weakness, headache, hyperglycaemia and hypertension. Investigations revealed very high 24-hour urine cortisol of 90 524, ectopic adrenocorticotropic hormone secreting pheochromocytoma, normal metanephrine levels and empty sella, which has never been reported. CT chest and abdomen revealed enlarged left adrenal gland with large necrotic mass 4.7\u00d74.0\u2009cm most likely neoplastic lesion. The patient was cured after surgical removal of the left adrenal mass. Histological examination revealed 3.5\u00d72.5\u00d72\u2009cm mass consistent with pheochromocytoma. After surgery and a short stay in the intensive care unit, the patient started improving and both antihypertensive treatment and insulin injections were withdrawn.<\/jats:p>","DOI":"10.1136\/bcr-2021-248607","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T13:04:31Z","timestamp":1653311071000},"page":"e248607","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Cushing syndrome due to ectopic ACTH secreting pheochromocytoma"],"prefix":"10.1136","volume":"15","author":[{"given":"Muhammad","family":"Naeem Durrani","sequence":"first","affiliation":[{"name":"The Aga Khan University Hospital Main Campus Karachi, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0151-8146","authenticated-orcid":false,"given":"Ubaidullah","family":"Popal","sequence":"additional","affiliation":[{"name":"Tabba Heart Institute, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,5,11]]},"reference":[{"key":"2025082622401606000_15.5.e248607.1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.86.1.117"},{"key":"2025082622401606000_15.5.e248607.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1994.tb02486.x"},{"key":"2025082622401606000_15.5.e248607.3","first-page":"809","article-title":"Screening tests for Cushing's syndrome","volume":"33","author":"Ambrosi","year":"1990","journal-title":"Clin Endocrinol"},{"key":"2025082622401606000_15.5.e248607.4","unstructured":"Melmed S , Polonsky KS , Larsen PR , et al . Williams textbook of endocrinology E-Book. Elsevier Health Sciences, 2015 Nov 11."},{"key":"2025082622401606000_15.5.e248607.5","first-page":"269","article-title":"[Association of a pheochromocytoma and Cushing type hypercorticism with hyperaldosteronuria]","volume":"25","author":"Bourgoignie","year":"1964","journal-title":"Ann Endocrinol"},{"key":"2025082622401606000_15.5.e248607.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2009.08.002"},{"key":"2025082622401606000_15.5.e248607.7","doi-asserted-by":"publisher","DOI":"10.1016\/0026-0495(79)90097-0"},{"key":"2025082622401606000_15.5.e248607.8","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2007.0016"},{"key":"2025082622401606000_15.5.e248607.9","doi-asserted-by":"publisher","DOI":"10.1038\/ncpendmet0327"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-248607","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T05:40:22Z","timestamp":1756273222000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-248607"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5]]},"references-count":9,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5,11]]},"published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1136\/bcr-2021-248607"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-248607","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5]]}}}