# A Pheochromocytoma With Adrenocorticotropic Hormone Secretion and Subsequent Fatal Outcome: A Case Report

## TL;DR

A rare case of a fatal pheochromocytoma that also secreted ACTH is reported, emphasizing the need for timely diagnosis and treatment.

## Contribution

This case report adds to the understanding of the rare and dangerous condition of ACTH-secreting pheochromocytoma.

## Key findings

- A 66-year-old male with ACTH-secreting pheochromocytoma presented with hypercortisolemia and hypercatecholaminemia.
- Despite preoperative management, the patient experienced sudden cardiopulmonary arrest and died.
- The case underscores the importance of prompt diagnosis and intervention for ACTH-secreting pheochromocytoma.

## Abstract

Hypercortisolemia and hypercatecholaminemia in ectopic adrenocorticotropic hormone (ACTH)-secreting pheochromocytoma represent life-threatening conditions, particularly when diagnosis is delayed. In this case, a 66-year-old male patient with poorly controlled diabetes presented with severe constipation in the absence of the classic Cushingoid phenotype. Computed tomography revealed bilateral adrenal masses, and 123I-metaiodobenzylguanidine scintigraphy revealed radiotracer uptake in the left adrenal gland. Endocrine assessments confirmed elevated catecholamine, ACTH, and cortisol levels, indicating an ACTH-secreting pheochromocytoma. Despite preoperative management with osilodrostat and alpha-blockers, the patient experienced sudden cardiopulmonary arrest and succumbed. This case highlights that prompt diagnosis and intervention are particularly important in ACTH-secreting pheochromocytoma.