This protocol addresses thymic carcinoid presenting with Cushing's syndrome caused by ectopic adrenocorticotropic hormone (ACTH) secretion. Ectopic ACTH-driven Cushing's syndrome is the most frequent functional syndrome encountered in thymic carcinoid.
The co-occurrence of Cushing's syndrome from ectopic ACTH secretion substantially shapes the clinical priorities. Managing cortisol excess is a central consideration alongside tumour-directed care.
When Cushing's syndrome becomes refractory in this setting, surgical intervention is among the options addressed in the full protocol — alongside selected pharmacological strategies targeting cortisol excess. The complete evidence-based regimen, decision criteria, and sequencing are available via the link below.
DOI: 10.1016/j.annonc.2021.01.003
CuS caused by ectopic ACTH secretion is the most frequent functional syndrome in ThC.
In patients with refractory CuS, early bilateral adrenalectomy should be considered [IV, B]
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