Ectopic Adrenocorticotropic Hormone Syndrome Due to Metastatic Prostate Cancer With Neuroendocrine Differentiation

Soundarrajan, Malini; Zelada, Henry; Fischer, Jean Victoria; Kopp, Peter

doi:10.4158/accr-2018-0429

Cited by 6 publications

(9 citation statements)

References 20 publications

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“…Immunohistochemistry showing positivity for synaptophysin also favoured a diagnosis of metastatic adenocarcinoma of the prostate with neuroendocrine differentiation (ICD-O code 8574/3) 19. The likelihood of this diagnosis was also due to the metastasis and neuroendocrine differentiation of our patient’s tumour after docetaxel12 15 16 and enzalutamide therapy.…”

Section: Discussionmentioning

confidence: 58%

“…Prostate cancer is the second most common cancer and the third leading cause of cancer-related death in men worldwide 5. Although rare, prostate cancer can differentiate into neuroendocrine, small cell and adenocarcinomas with ectopic ACTH secretion 6–15. Neuroendocrine differentiation has been documented to be induced by radiotherapy, chemotherapy and androgen-deprivation therapy and has been associated with prostate cancer progression and poor prognosis 16…”

Section: Introductionmentioning

confidence: 99%

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ACTH-secreting metastatic prostate cancer with neuroendocrine differentiation

et al. 2022

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Cushing’s syndrome (CS) due to ectopic adrenocorticotropic hormone (ACTH) secretion (EAS) can result from a variety of tumours and rarely from those of prostatic origin. We present a male patient in his early 60s with ACTH-secreting metastatic prostate adenocarcinoma with neuroendocrine differentiation (ICD-O code 8574/3) years after prostatectomy and androgen-deprivation therapy, initially presenting with Cushingoid features. After open radical prostatectomy and bilateral orchiectomy for disease recurrence, the patient was found to have metastatic liver and bone lesions highly suggestive of metastatic prostatic cancer. About 10% of cells on liver biopsy expressed ACTH, a finding consistent with EAS as the cause of CS. His stay was complicated with multiple infections and ultimate death. Hence, we report a case of metastatic prostate adenocarcinoma with neuroendocrine differentiation who presented with CS. We also emphasize the importance of adequate and timely treatment.

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Section: Discussionmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

ACTH-secreting metastatic prostate cancer with neuroendocrine differentiation

et al. 2022

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“…There were several presentations, but hypokalemia, resistant hypertension, and fluid overload were documented frequently. Furthermore, 7 out of 11 patients with paraneoplastic CS had a previous history of prostate adenocarcinoma, for which they were treated with ADT before developing neuroendocrine differentiation and CS [ 10 , 16 , 17 , 18 , 19 , 20 , 21 ]. Small cell carcinoma was the predominant histological subtype, with one case having a large cell NEPC [ 14 , 15 , 19 , 20 , 21 , 22 , 23 ].…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, 7 out of 11 patients with paraneoplastic CS had a previous history of prostate adenocarcinoma, for which they were treated with ADT before developing neuroendocrine differentiation and CS [ 10 , 16 , 17 , 18 , 19 , 20 , 21 ]. Small cell carcinoma was the predominant histological subtype, with one case having a large cell NEPC [ 14 , 15 , 19 , 20 , 21 , 22 , 23 ]. In addition, Prostate Specific Antigen (PSA) levels were high in patients who reported a previous history of prostate adenocarcinoma [ 10 , 16 , 18 , 20 , 21 ] but were normal in patients who developed prostate neuroendocrine cancer de novo [ 14 , 15 , 23 ].…”

Section: Resultsmentioning

confidence: 99%

Paraneoplastic Syndromes in Neuroendocrine Prostate Cancer: A Systematic Review

Abufaraj,

Ramadan,

Alkhatib

2024

Current Oncology

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Neuroendocrine prostate cancer (NEPC) is a rare subtype of prostate cancer (PCa) that usually results in poor clinical outcomes and may be accompanied by paraneoplastic syndromes (PNS). NEPC is becoming more frequent. It can initially manifest as PNS, complicating diagnosis. Therefore, we reviewed the literature on the different PNS associated with NEPC. We systematically reviewed English-language articles from January 2017 to September 2023, identifying 17 studies meeting PRISMA guidelines for NEPC and associated PNS. A total of 17 articles were included in the review. Among these, Cushing’s Syndrome (CS) due to ectopic Adrenocorticotropic hormone (ACTH) secretion was the most commonly reported PNS. Other PNS included syndrome of inappropriate Anti-Diuretic Hormone secretion (SIADH), Anti-Hu-mediated chronic intestinal pseudo-obstruction (CIPO), limbic encephalitis, Evans Syndrome, hypercalcemia, dermatomyositis, and polycythemia. Many patients had a history of prostate adenocarcinoma treated with androgen deprivation therapy (ADT) before neuroendocrine features developed. The mean age was 65.5 years, with a maximum survival of 9 months post-diagnosis. NEPC is becoming an increasingly more common subtype of PCa that can result in various PNS. This makes the diagnosis and treatment of NEPC challenging. Further research is crucial to understanding these syndromes and developing standardized, targeted treatments to improve patient survival.

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“…Various paraneoplastic syndromes that have been reported to be associated with prostate cancer are SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome [ 4 ], hyperfibrinolysis [ 5 ], giant cell arteritis [ 6 ], Cushing syndrome [ 7 ], Stauffer syndrome [ 8 ], anti-Hu mediated intestinal pseudo-obstruction [ 9 ], and SIADH (syndrome of inappropriate antidiuretic hormone secretion) [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Paraneoplastic Evans Syndrome in a Patient With Prostate Cancer With Small Cell Transformation

Sidda¹,

Manu²,

Abdallah³

et al. 2022

Cureus

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Paraneoplastic syndromes are defined as tumor‐associated indirect systemic effects. Prostate cancer-associated paraneoplastic syndromes typically have endocrine, neurologic, and dermatologic manifestations. Reports have suggested up to 70% of metastatic prostate cancers manifest as paraneoplastic entities. Although common in hematological malignancies, it is rare for prostate cancer and other solid tumors to be associated with immune-mediated cytopenias such as Evans syndrome. Based on our PubMed search for the keywords Evans syndrome and prostate cancer, only one other case has been reported in the literature with this association. We report the second such case in a 63-year-old male who initially presented with hemolytic anemia and thrombocytopenia. He was diagnosed with Evans syndrome with initial responses to both steroids and intravenous immunoglobulin. Extensive workup, including an eventual bone marrow biopsy, revealed metastatic prostate cancer with transformation to small cell neuroendocrine carcinoma.

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Ectopic Adrenocorticotropic Hormone Syndrome Due to Metastatic Prostate Cancer With Neuroendocrine Differentiation

Cited by 6 publications

References 20 publications

ACTH-secreting metastatic prostate cancer with neuroendocrine differentiation

ACTH-secreting metastatic prostate cancer with neuroendocrine differentiation

Paraneoplastic Syndromes in Neuroendocrine Prostate Cancer: A Systematic Review

Paraneoplastic Evans Syndrome in a Patient With Prostate Cancer With Small Cell Transformation

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