Cushing's syndrome secondary to ectopic ACTH secretion from metastatic breast carcinoma

Wigg, Susan J; Ehrlich, Allison R.; Fuller, Peter J.

doi:10.1046/j.1365-2265.1999.00726.x

Cited by 13 publications

(14 citation statements)

References 12 publications

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“…Ectopic ACTH secretion has been described in a wide number of neoplasms: non-small-cell lung carcinoma [9], small-cell lung carcinoma, carcinoid tumors (bronchopulmonary, thymic and gastrointestinal origin), pancreatic islet tumors, pheocromocytoma, thyroid's medullary carcinoma [18] and a host of other tumors, such as paraganglioma [19], prostate [20], breast [21,22], kidneys [23], stomach [24], ovaries [25], melanoma [26], colon [27], leukemia [28], anorectal tumors [29], and even in inflammatory tissues [30]. Among these, the bronchopulmonary carcinoid tumor remains the most prevalent [18].…”

Section: Discussionmentioning

confidence: 99%

Cushing's syndrome secondary to bronchopulmonary carcinoid tumor: Report of two cases and literature review

et al. 2006

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Section: Discussionmentioning

confidence: 99%

Cushing's syndrome secondary to bronchopulmonary carcinoid tumor: Report of two cases and literature review

et al. 2006

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“…Ectopic ACTH production has been described in small cell carcinoma of the lung, bronchial carcinoid tumors, pancreatic islet cell tumors, thymic carcinoid tumors, pheochromocytomas, and breast carcinoma. 4,5 Overall, bronchopulmonary carcinoids are the most common neoplasm implicated in ectopic ACTHdependent Cushing's syndrome. 6 In patients with Cushing's syndrome, the time to diagnosis of an underlying carcinoid may take months to years owing to the frequent absence of pulmonary symptoms and the fact that only 1% of Cushing's diagnoses are attributable to carcinoids.…”

Section: Discussionmentioning

confidence: 99%

Cushing's syndrome and nocardiosis associated with a pulmonary carcinoid tumor: Report of a case and review of the literature

Sutton

Parks

Manavi

et al. 2010

Diagnostic Cytopathology

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Ectopic hormone production is an uncommon complication of neoplastic lung disease. Rarely, patients may present with signs and symptoms of systemic endocrine dysfunction related to a hormone-secreting tumor. Bronchopulmonary carcinoids are the most common neoplasm implicated in ectopic ACTH-dependent Cushing's syndrome. Persistent hypercortisolism, such as that which occurs in Cushing's syndrome, causes immunosuppression and makes patients vulnerable to opportunistic infections. We present a case of a 42-year-old woman diagnosed with ACTH-dependent Cushing's syndrome which was originally thought to stem from a pituitary lesion as interpreted on magnetic resonance imaging. Her symptoms persisted after undergoing hypophysectomy, and further work-up involving a fine needle aspiration of the left lung revealed an ACTH-producing carcinoid tumor. Before treatment could be administered, the patient developed several new suspicious nodules in the left lung that were shown by fine needle aspiration to be infectious in nature. A Gram stain revealed numerous Gram positive branching organisms, and culture of the specimen grew Nocardia asteroides. Her pulmonary infection was treated with antibiotics and she underwent successful ablation of the carcinoid tumor.

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“…23 Ectopic ACTH production resulting in CS is associated with a variety of solid tumors, mostly of neuroendocrine origin. 25 The clinical presentation varies and reflects the underlying tumor type and the rapidity and severity of the hypercortisolism. Ectopic ACTH secretion accounts for 10% to 15% of cases of ACTH-dependent CS.…”

Section: Discussionmentioning

confidence: 99%

“…24 Various benign and malignant tumors have been associated with ectopic ACTH. 12,[25][26][27] Serum electrolyte abnormalities are more common in ectopic ACTH syndrome than other forms of CS. 25 The clinical presentation varies and reflects the underlying tumor type and the rapidity and severity of the hypercortisolism.…”

Section: Discussionmentioning

confidence: 99%

Hypertension, Diabetes, Hypokalemia, and Metabolic Alkalosis

Erem¹,

Koçak²,

Ersöz³

et al. 2010

The Endocrinologist

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Prostate adenocarcinoma is a very rare cause of ectopic adrenocorticotropic hormone (ACTH) syndrome. We report the case of a 70-yearold man who presented with clinical and biochemical features of ACTHdependent Cushing syndrome secondary to prostate carcinoma. On admission, his blood pressure was 170/100 mm Hg. Physical examination revealed signs of excessive production of cortisol. Laboratory values were consistent with hypokalemia and metabolic alkalosis. Elevated serum cortisol, ACTH, and urine free cortisol levels were found. Cortisol was not suppressed with an overnight 1-mg oral dexamethasone suppression test (DST), 2-day low-dose DST, or overnight 8.0-mg high-dose DST. Chest computed tomography showed multiple parenchymal nodules in the right lung, consistent with metastatic disease. Whole-body bone scintigraphy revealed numerous foci of increased radiotracer uptake in the femur and axial skeleton, consistent with metastatic disease. Bone survey (radiography) showed generalized osteolytic metastases. Histologic analysis of a prostatic biopsy showed prostate adenocarcinoma. Immunostaining of the prostate adenocarcinoma for ACTH was positive. The severe metabolic alkalosis due to glucocorticoid-induced mineralocorticoid excess was treated with potassium supplements and spironolactone. This case is a remarkable example of the complex metabolic endocrine manifestations that can accompany prostate adenocarcinoma.

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Cushing's syndrome secondary to ectopic ACTH secretion from metastatic breast carcinoma

Cited by 13 publications

References 12 publications

Cushing's syndrome secondary to bronchopulmonary carcinoid tumor: Report of two cases and literature review

Cushing's syndrome secondary to bronchopulmonary carcinoid tumor: Report of two cases and literature review

Cushing's syndrome and nocardiosis associated with a pulmonary carcinoid tumor: Report of a case and review of the literature

Hypertension, Diabetes, Hypokalemia, and Metabolic Alkalosis

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