Cushing's paraneoplastic syndrome as first manifestation of an adenocarcinoma of unknown origin

Garrido, María José Molina; Ponce, Carmen Guillén; Escalante, Sonia; Sanz, Vanesa Pons; Mena, Alfredo Carrato

doi:10.1007/s12094-006-0071-3

Cited by 10 publications

(7 citation statements)

References 13 publications

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“…Her clinical features such as hyperpigmentation and severe muscle weakness are among less common presentations. 5 11β-hydroxysteroid dehydrogenase type 1 (11-βHSD1) is an enzyme responsible for converting cortisone (inactive glucocorticoid) into cortisol (active). It is speculated that this enzyme has a role in obesity (Figure 2).…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Cushing’s Disease Presenting With Psychosis and Muscle Weakness Postpartum

Eskandari,

Ziaee,

Samadanifard

et al. 2023

Journal of Investigative Medicine High Impact Case Reports

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Cushing’s syndrome is a condition leading to overproducing of cortisol by the adrenal glands. If the pituitary gland overproduces cortisol, it is called Cushing’s disease. Cushing’s syndrome and even Cushing’s disease during and after pregnancy are rare events. There is not enough literature and guidance for managing and treating these patients. The diagnosis of Cushing’s syndrome in pregnancy is often delayed because the symptoms overlap. We presented a thin 31-year-old woman, admitted 2 months after a normal-term delivery, with an atypical presentation of Cushing’s disease, unusual clinical features, and a challenging clinical course. She had no clinical discriminatory features of Cushing’s syndrome. Given that the patient only presented with psychosis and proximal myopathy and had an uncomplicated pregnancy, our case was considered unusual. The patients also had hyperpigmentation and severe muscle weakness which are among the less common presentations of Cushing’s syndrome. Our findings suggest that an early diagnosis of Cushing’s disease is important in pregnancy period for its prevalent fetal and maternal complications, and it should be treated early to optimize fetal and maternal outcomes as there is an increasing trend toward live births in treated participants.

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Section: Discussionmentioning

confidence: 99%

A Case Report of Cushing’s Disease Presenting With Psychosis and Muscle Weakness Postpartum

Eskandari,

Ziaee,

Samadanifard

et al. 2023

Journal of Investigative Medicine High Impact Case Reports

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“…Common causes of ectopic ACTH secretion include small-cell lung carcinoma (SCLC), bronchial carcinoid, and neuroendocrine tumor of the lung, small intestines, and the pancreas [23]. ymic carcinoid and medullary carcinoma of the thyroid may also secrete ACTH, but these are rare [24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Ectopic Cushing’s Syndrome Secondary to Metastatic Paraganglioma

Daya

Wingfield

Sotshononda

et al. 2021

Case Reports in Endocrinology

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Paraneoplastic or ectopic Cushing’s syndrome (CS) is a rare cause of endogenous hypercortisolism. It is due to ectopic adrenocorticotropic hormone (ACTH) secretion and has been reported in association with a variety of neuroendocrine tumors such as small-cell lung carcinoma, carcinoid tumors, and medullary carcinoma of the thyroid. Paragangliomas (PGLs) are rare neuroendocrine tumors that can secrete catecholamines. Case reports and reports of ectopic ACTH secretion from metastatic PGLs causing CS are exceedingly rare. We present a case of a 38-year-old female, who presented with typical signs, symptoms, and complications of CS, secondary to a PGL with widespread metastases, which eventually led to her demise.

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“…Tumors can be identified usually with one or more than one syndrome simultaneously (as paraneoplastic ectopic Cushing, syndrome of inappropriate antidiuretic hormone secretion (SIADH), Lambert-Eaton, hypercalcemia, hypercalcitoninemia), especially when arising from a neuroendocrine tumor (4). Many cases reported the presence of 2 paraneoplastic syndromes in SCLC.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical resection of the primary tumor with lymphadenectomy is beneficial when performed for localized tumors, but it is often impossible in the advanced setting (4, 14). …”

Section: Discussionmentioning

confidence: 99%

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Case-series of paraneoplastic Cushing syndrome in small-cell lung cancer

Richa

Saad

Halabi³

et al. 2018

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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SummaryThe objective of this study is to report three cases of paraneoplastic or ectopic Cushing syndrome, which is a rare phenomenon of the adrenocorticotropic hormone (ACTH)-dependent Cushing syndrome. Three cases are reported in respect of clinical presentation, diagnosis and treatment in addition to relevant literature review. The results showed that ectopic ACTH secretion can be associated with different types of neoplasm most common of which are bronchial carcinoid tumors, which are slow-growing, well-differentiated neoplasms with a favorable prognosis and small-cell lung cancer, which are poorly differentiated tumors with a poor outcome. The latter is present in two out of three cases and in the remaining one, primary tumor could not be localized, representing a small fraction of patients with paraneoplastic Cushing. Diagnosis is established in the setting of high clinical suspicion by documenting an elevated cortisol level, ACTH and doing dexamethasone suppression test. Treatment options include management of the primary tumor by surgery and chemotherapy and treating Cushing syndrome. Prognosis is poor in SCLC. We concluded that in front of a high clinical suspicion, ectopic Cushing syndrome diagnosis should be considered, and identification of the primary tumor is essential.Learning points:Learning how to suspect ectopic Cushing syndrome and confirm it among all the causes of excess cortisol.Distinguish between occult and severe ectopic Cushing syndrome and etiology.Providing the adequate treatment of the primary tumor as well as for the cortisol excess.Prognosis depends on the differentiation and type of the primary malignancy.

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Cushing's paraneoplastic syndrome as first manifestation of an adenocarcinoma of unknown origin

Cited by 10 publications

References 13 publications

A Case Report of Cushing’s Disease Presenting With Psychosis and Muscle Weakness Postpartum

A Case Report of Cushing’s Disease Presenting With Psychosis and Muscle Weakness Postpartum

Ectopic Cushing’s Syndrome Secondary to Metastatic Paraganglioma

Case-series of paraneoplastic Cushing syndrome in small-cell lung cancer

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