{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T11:00:44Z","timestamp":1784718044858,"version":"3.55.0"},"reference-count":17,"publisher":"The Endocrine Society","issue":"8","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS) often involves occult microtumors, making localization challenging. We report a 68-year-old woman with severe ACTH-dependent hypercortisolism in whom the primary tumor remained occult despite extensive imaging, including 68Ga-tetraazacyclododecanetetraacetic acid-D-Phe(1)-Tyr(3)-octreotide positron emission tomography\/computed tomography. Based on a positive octreotide challenge test, she received long-acting release octreotide for over a decade, achieving sustained biochemical stability. In 2020, she developed breast cancer, with the tumor being ACTH-negative on immunohistochemistry. In 2023, during resection of pulmonary metastases of the breast cancer, a 3-mm nodule was incidentally discovered in the adjacent lung tissue. Through close interdisciplinary coordination, the nodule was removed and was confirmed as an ACTH- and somatostatin receptor (SSTR) 2-positive pulmonary carcinoid. Thereafter, the EAS resolved completely with prompt recovery of adrenal function. In this case, intensive medical stabilization in occult EAS probably served as a strategic \u201cbridge to surgery.\u201d Importantly, long-term biochemical control using somatostatin analogs facilitated prompt recovery of the hypothalamic\u2013pituitary\u2013adrenal axis immediately after tumor resection. This may also have preserved SSTR2 expression, potentially by mitigating cortisol-induced receptor downregulation, facilitating its eventual localization. This report shows that meticulous multidisciplinary communication during unrelated surgical procedures is indispensable for identifying radiologically occult lesions.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag204","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:50:27Z","timestamp":1783511427000},"source":"Crossref","is-referenced-by-count":0,"title":["Fourteen-year bridge to cure in occult ectopic ACTH syndrome: resection of a 3-mm pulmonary carcinoid"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4830-7154","authenticated-orcid":false,"given":"Nobuyuki","family":"Koriyama","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrine Medicine, NHO Kagoshima Medical Center , Kagoshima 892-0853 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiko","family":"Obo","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrine Medicine, NHO Kagoshima Medical Center , Kagoshima 892-0853 ,","place":["Japan"]},{"name":"Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medicine and Dental Sciences, Kagoshima University , Kagoshima 890-8520 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9626-0127","authenticated-orcid":false,"given":"Kazuma","family":"Ogiso","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrine Medicine, NHO Kagoshima Medical Center , Kagoshima 892-0853 ,","place":["Japan"]},{"name":"Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medicine and Dental Sciences, Kagoshima University , Kagoshima 890-8520 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuharu","family":"Nomoto","sequence":"additional","affiliation":[{"name":"Department of Pathology, NHO Kagoshima Medical Center , Kagoshima 892-0853 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Sakasegawa","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Kagoshima City Hospital , Kagoshima 890-8760 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiko","family":"Nishio","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrine Medicine, NHO Kagoshima Medical Center , Kagoshima 892-0853 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"issue":"2","key":"2026072206005633900_luag204-B1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1210\/jendso\/bvae194","article-title":"Recognition and management of ectopic ACTH secreting tumors","volume":"9","author":"Elenius","year":"2025","journal-title":"J Endocr 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