Co-secretion of calcitonin gene-related peptide, gastrin-releasing peptide and ACTH by a carcinoid tumour metastasizing to the cerebellum

Ghatei, Mohammad A.; Stratton, M. R.; Allen, J.M.; Joplin, G. F.; Polak, J.M.; Bloom, S.R.

doi:10.1136/pgmj.63.736.123

Cited by 14 publications

(5 citation statements)

References 39 publications

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“…Some data pertaining to six of our ectopic group have been reported by Davies et al [2]. Our Patients A.B.C, D, E, F, are those referred to before as Patients2, 3,4,10, 9,8. Our Patient E was reported by Ghatei et al [7] in considerable biochemical detail.…”

Section: Ectopic Acth Groupsupporting

confidence: 73%

An Evaluation of the Distinction of Ectopic and Pituitary ACTH Dependent Cushing's Syndrome by Clinical Features, Biochemical Tests and Radiological Findings

Blunt

Sandler

Burrin

et al. 1990

QJM

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The efficiency of various laboratory and radiological investigations in the differentiation of ectopic from pituitary dependent Cushing's syndrome was studied, based on findings in 23 patients with verified Cushing's disease and seven patients with the ectopic ACTH syndrome. Clinical features strongly favouring the ectopic type were male sex and history for less than 18 months. Basal biochemical features strongly indicating the ectopic syndrome included plasma K + < 3.0 mmol/1 and HCO 3 > 30 mmol/1; serum cortisol at 9 a.m. or midnight of > 800 nmol/1; urine free cortisol > 1300 nmol/24 hours; plasma ACTH > 100 ng/1. In the high-dose dexamethasone suppression test, suppression by < SO per cent of 9 a.m. serum cortisol, urine free cortisol or 17-oxogenic steroids was usually indicative of an ectopic source of ACTH. A mean suppressed value of > 450 nmol/1 for the 9 a.m. and midnight cortisol combined occurred in all of those with the ectopic syndrome, but in none of the 23 patients with Cushing's disease. For urine free cortisol, a mean suppressed value of < 1000 nmol/24 hours was found in all patients with Cushing's disease, but in none of those in the ectopic group. In the metyrapone test, there was an increase of < 3-fold in 11-deoxycortisol at 24 hours in patients with ectopic ACTH; the increase was > 3-fold in all but one of the patients with Cushing's disease. Failure to respond to either dexamethasone or metyrapone was found in only one of the patients with Cushing's disease (Patient 16); in the ectopic group, all patients except Patient D failed to respond to either test. It is concluded that patients presenting with clinically obvious Cushing's syndrome along with measurable plasma ACTH can be reliably divided by conventional tests into those that are driven from the pituitary and those driven by ectopic ACTH.

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Section: Ectopic Acth Groupsupporting

confidence: 73%

An Evaluation of the Distinction of Ectopic and Pituitary ACTH Dependent Cushing's Syndrome by Clinical Features, Biochemical Tests and Radiological Findings

Blunt

Sandler

Burrin

et al. 1990

QJM

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“…Neuroendocrine tumors often express at least one metabolically active peptide or amine [11]. Pulmonary carcinoid tumor cells secrete adrenocorticotropic hormone (ACTH), serotonin and calcitonin [11][12][13][14]. However, clinical syndromes such as Cushing's syndrome and carcinoid syndrome are rare and affect only 1-6% of PC patients [6].…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological indicators of survival among patients with pulmonary carcinoid tumor

et al. 2018

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We conclude that PCs are uncommon tumors. When resected, the long-term survival is in general favorable. In this consecutive, single-institution cohort of patients, presence of metastatic disease, tumor size, histological subtype and Ki-67 index were associated with shorter disease-specific survival. As TC and AC have different clinical behaviors, the correct tumor classification at the time of diagnosis is a necessity.

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“…Survival time presented in case reports varies from several weeks to several months. [5][6][7][8][9][10][11][12][13][14][15][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Patchell and Posner 16 reported a median survival time of 7 months, with 33 % of these patients surviving for Ͼ 1 year. In our patients, the overall median survival time after the diagnosis of brain metastasis was 10 months (95% CI, 4 -16 months), with 42 % of patients surviving for Ն 1 year.…”

Section: Discussionmentioning

confidence: 99%

Carcinoid metastasis to the brain

Hlatky

Suki

Sawaya

2004

Cancer

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BACKGROUND.Carcinoid tumors rarely metastasize to the brain. The objectives of the current study were to assess the frequency of brain metastasis from carcinoid tumors, determine correlates of survival, and describe treatment modalities and their outcomes. METHODS. BetweenJanuary 1977 and December 2003, 1633 patients with a carcinoid tumor were registered at The University of Texas M. D. Anderson Cancer Center. Of those, 24 patients (1.5%) had a diagnosis of brain metastasis. The authors collected demographic and clinical data and performed a statistical analysis. RESULTS.The median age at the time patients were diagnosed with brain metastasis was 60 years. The metastases were treated with whole-brain radiotherapy (WBRT) alone in 7 patients (29%), and 12 patients (50%) underwent surgical resection, 7 of whom (29%) also received WBRT. The median survival time for the entire cohort after diagnosis of the primary tumor was 2.3 years (95% confidence interval [CI], 0.5-4.1 years), and the median survival time after the diagnosis of brain metastasis was 10.0 months (95% CI, 4.0 -16.0 months). The longest median survival observed after the diagnosis of brain metastasis (3.2 years) occurred in patients who underwent resection and received WBRT. In the multivariate analysis, the adjusted rate ratio for comparison of all treatments versus combination of neurosurgical intervention and WBRT was 5.7 (95% CI, 1.3-26.1; P ϭ 0.024). A positive effect of surgery followed by WBRT on the duration of survival was detected in patients with a single metastasis (P ϭ 0.084) as well as in those with multiple metastases (P ϭ 0.018). CONCLUSIONS.Prolonged survival was observed in patients Ͻ 65 years old as well as in those who underwent surgery and received WBRT in comparison with other treatments. Whenever feasible, neurosurgical resection followed by WBRT seems to be the indicated treatment in patients with brain metastases from carcinoid tumors.

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Co-secretion of calcitonin gene-related peptide, gastrin-releasing peptide and ACTH by a carcinoid tumour metastasizing to the cerebellum

Cited by 14 publications

References 39 publications

An Evaluation of the Distinction of Ectopic and Pituitary ACTH Dependent Cushing's Syndrome by Clinical Features, Biochemical Tests and Radiological Findings

An Evaluation of the Distinction of Ectopic and Pituitary ACTH Dependent Cushing's Syndrome by Clinical Features, Biochemical Tests and Radiological Findings

Clinicopathological indicators of survival among patients with pulmonary carcinoid tumor

Carcinoid metastasis to the brain

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