Delayed diagnosis of ectopic ACTH-secreting tumors following transsphenoidal surgery for presumed magnetic resonance imaging (MRI)-negative Cushing’s disease: implications for long-term surveillance
Authors' conclusion
Differentiating between pituitary adenoma and ectopic tumors remains challenging in MRI-negative cases.
Study context
- Population
- Patients who underwent transsphenoidal surgery (TSS) for presumed Cushing's disease (CD) (1992–2026) with no identifiable pituitary adenoma on the highest-quality preoperative MRIof 530 reviewed
- Participants
- 57 patients
- Outcome
- Long-term diagnostic outcomes of MRI-negative ACTH-dependent Cushing's syndrome
- Follow-up
- Long-term
Main finding
As reported in the abstract
Ultimately diagnosed with ectopic ACTH-secreting tumors
- Diagnosed with ectopic ACTH-secreting tumors
- 5 of 57 patients
- Ectopic tumors detected ≈2 years after surgery (pulmonary, adrenal, pancreatic NET)
- 3 patients
- Pulmonary NET and thymic NET identified 9 and 18 years later, respectively
- 2 patients
- Bilateral inferior petrosal sinus sampling (BIPSS) indicated a pituitary source
- 4 patients
- BIPSS indicated an ectopic source
- 1 patient
Observational data: associations, not effects.
Original publication
Delayed diagnosis of ectopic ACTH-secreting tumors following transsphenoidal surgery for presumed MRI-negative Cushing’s disease: implications for long-term surveillance. Pituitary. Published 28 July 2026. doi:10.
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