Paraneoplastic Cushing's syndrome and hypercalcemia arising from metastatic endometrioid endometrial adenocarcinoma: A case report

Mitchell, Evelyn; Ciccone, Marcia A.; Zhang, Bing; Tsai, Albert; Brunette, Laurie L.

doi:10.1016/j.gore.2019.06.005

Cited by 6 publications

(5 citation statements)

References 15 publications

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“…According the literature, approximately two-third of the ovarian small cell carcinoma would co-occur with hypercalcemia. 13 In endometrial cancer, the occurrence of hypercalcemia is very rare, only few cases combined with HHM have been reported 14 – 17 ( Table 3 ). In our case, although the serum calcium level dropped after receiving medications, her condition was getting worse since the primary tumor was incapable to treat effectively.…”

Section: Discussionmentioning

confidence: 99%

The co-occurrence of leukemoid reaction and hypercalcemia in a patient with endometrial cancer: A case report and literature review

et al. 2021

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Paraneoplastic syndromes are rarely seen in gynecological tumors especially in endometrial cancer. Early identification of paraneoplastic syndromes plays a significant role in the treatment and prognosis of cancer. Here, we reported a rare case with endometrial cancer with a 2.7 cm × 2.2 cm × 3.4 cm lesion in the posterior cervix presenting leukemoid reaction and hypercalcemia as paraneoplastic syndromes simultaneously. During the progress of the endometrial cancer, her leukocyte level rose up to 60.7 × 109/L after anti-infection treatment. Meanwhile, the patient represented a series of severe clinical situation including hypercalcemia, hypokalemia, metabolic alkalosis. and respiratory failure. Finally, the patient died of respiratory circulatory failure 2 weeks later. In addition to symptomatic treatment, possible treatment targeted on the primary tumor as early as possible might help to improve the clinical prognosis.

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Section: Discussionmentioning

confidence: 99%

The co-occurrence of leukemoid reaction and hypercalcemia in a patient with endometrial cancer: A case report and literature review

et al. 2021

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“…PCS arises from tumour secretion of ACTH or CRH, resulting in production and release of cortisol from the adrenal glands. Unlike paraneoplastic endocrine syndromes that present most of the time after cancer diagnosis, PCS typically appears before cancer detection and similarly relapse may herald tumour recurrence [ 11 , 14 ]. In our case, no symptoms related to hypercortisolaemia led the patient to consult before obstructive syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…PCS can cause a poor clinical outcome due to various complications with an increase in susceptibility to infection and GI ulceration. Indeed, for small-cell lung cancer and gynaecological malignancies, PCS is associated with accelerated decompensation and poorer response to chemotherapy (Mitchell et al [ 14 ]). Whether these findings can be extrapolated to other malignancies is unknown.…”

Section: Discussionmentioning

confidence: 99%

Paraneoplastic Cushing Syndrome in Gastrointestinal Neuroendocrine Tumour

Mineur¹,

Boustany²,

Vazquez³

2021

Case Rep Oncol

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Ectopic production of adrenocorticotropic hormone (ACTH) by gastrointestinal neuroendocrine tumours (NETs) is relatively uncommon. We report a rare case of a liver metastatic G1 low-grade NET of the intestine that induced hypercortisolism after surgical resection. A 50-year-old man was admitted for an intestinal obstruction caused by a tumour of the intestine. Paraneoplastic Cushing syndrome was diagnosed more than a year later following the appearance of cushingoid symptoms, despite stable disease according to RECIST criteria but chromogranin A increase. Ketoconazole and sandostatin medical treatment and liver chemoembolization never managed to control the hypercortisolism unlike the bilateral adrenalectomy. The identification and effective management of this uncommon statement of ectopic ACTH secretion is important to improve the patient’s prognosis and quality of life.

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“…3 Importantly, ectopic ACTH and, rarely, cortisol secretion has been observed, resulting from gynaecological neuroendocrine tumours, endometrial adenocarcinomas and ovarian teratomas. [22][23][24] Symptoms are the classic Cushingoid phenotype, which may or may not be accompanied by electrolyte disturbance (hypokalaemia). These clinical findings may pre-date those of malignancy, with the underlying neoplasm being found in the diagnostic work-up.…”

Section: Cushing's Syndromementioning

confidence: 99%

“…Most cases (50–60%) are attributed to neuroendocrine lung tumours; for example, small cell carcinoma 3 . Importantly, ectopic ACTH and, rarely, cortisol secretion has been observed, resulting from gynaecological neuroendocrine tumours, endometrial adenocarcinomas and ovarian teratomas 22–24 . Symptoms are the classic Cushingoid phenotype, which may or may not be accompanied by electrolyte disturbance (hypokalaemia).…”

Section: Endocrine Paraneoplastic Syndromementioning

confidence: 99%

Paraneoplastic syndrome associated with gynaecological malignancy: a review of the evidence

Brown

McKenna

Forbes

et al. 2022

The Obstetric & Gynaecologis

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Paraneoplastic syndrome (PNS) is a clinical manifestation of both benign and malignant tumours. Symptoms are not attributable to direct organ involvement of the cancer nor as a therapeutic adverse effect; instead, they are a result of hormones, cytokines or growth factors released by the tumour, or an immunological response. Paraneoplastic syndromes can affect any body system, so can cause myriad potential symptoms. These clinical manifestations often pre-date those of the underlying disease process.The incidence of PNS attributable to gynaecological tumours is increasing, resulting in considerable morbidity in those affected. There is an overall lack of awareness of PNS among clinicians; this, combined with wide-ranging signs and symptoms, creates an opportunity for diagnostic difficulty and therapeutic delay. Learning objectivesTo raise awareness among clinicians to aid earlier diagnosis and treatment of paraneoplastic syndromes.

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Paraneoplastic Cushing's syndrome and hypercalcemia arising from metastatic endometrioid endometrial adenocarcinoma: A case report

Cited by 6 publications

References 15 publications

The co-occurrence of leukemoid reaction and hypercalcemia in a patient with endometrial cancer: A case report and literature review

The co-occurrence of leukemoid reaction and hypercalcemia in a patient with endometrial cancer: A case report and literature review

Paraneoplastic Cushing Syndrome in Gastrointestinal Neuroendocrine Tumour

Paraneoplastic syndrome associated with gynaecological malignancy: a review of the evidence

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