Roentgenologic diagnosis of primary corticotropin-producing carcinoid tumors of the mediastinum.

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Abstract
A study was undertaken of 5 patients with Cushing syndrome due to ACTH production by thymic carcinoid tumor (primary mediastinal apudomas), including 2 recent patients examined by computed tomography (CT) of the chest. Plain roentgenography of the chest initially failed to detect tumor in 4 of the 5 patients, while CT of the chest yielded definitive diagnostic information in both patients in whom it was employed. For 1 of these patients, a mediastinal tumor could be seen retrospectively on plain roentgenograms of the chest, although it had been missed on the 1st examination. One of the tumors appeared to be partially calcified on CT scan, a finding not previously reported. Blastic osseous metastasis, which is common when malignant carcinoid tumors spread to bone, was seen in 1 patient. In patients with suspected ectopic ACTH production, CT scanning of the mediastinum should be performed early to avoid delay in diagnosis of an ACTH-secreting carcinoid tumor of the mediastinum.

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