Utility of Various Functional and Anatomic Imaging Modalities for Detection of Ectopic Adrenocorticotropin-Secreting Tumors

Zemskova, Marina; Gundabolu, Bhaskar; Sinaii, Ninet; Chen, Clara C.; Carrasquillo, Jorge A.; Whatley, Millie; Chowdhury, Iffat; Gharib, Ahmed M.; Nieman, Lynnette K.

doi:10.1210/jc.2009-2282

Cited by 87 publications

(117 citation statements)

References 21 publications

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“…It has been reported that FDG-PET for detection of the ectopic ACTH source has a sensitivity of 64% and positive predictive values of 53 % [2]. In this case, FDG-PET showed no significant uptake by the S7 tumor which was later identified as bronchial carcinoid tumor, but mild uptake by the S5 tumor which was found to be a cryptococcal granuloma.…”

Section: Reverse Transcription-polymerase Chain Reaction Detection (Rmentioning

confidence: 64%

“…It has been reported that SRS for detection of the ectopic ACTH source have sensitivity of 57 % and positive predictive values of 79 % [2]. SRS using 111 In-pentetreotide is a useful tool to detect neuroendocrine tumors with abundant expression of SSTRs [13], among which octreotide binds with higher affinity to SSTR-2 and SSTR-5.…”

Section: Reverse Transcription-polymerase Chain Reaction Detection (Rmentioning

confidence: 99%

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Ectopic ACTH syndrome caused by bronchial carcinoid tumor indistinguishable from Cushing's disease

et al. 2010

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Section: Reverse Transcription-polymerase Chain Reaction Detection (Rmentioning

confidence: 64%

Section: Reverse Transcription-polymerase Chain Reaction Detection (Rmentioning

confidence: 99%

Ectopic ACTH syndrome caused by bronchial carcinoid tumor indistinguishable from Cushing's disease

et al. 2010

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“…Reviewafter the administration of corticotrophin-releasing hormone (CRH) has become an established and widely used diagnostic procedure in patients with ACTH-dependent Cushing's syndrome, especially in those cases with a negative or equivocal pituitary MRI finding (89,90,91,92,93) (Fig. 5).…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

“…Only a few case reports exist in which ACTH-secreting bronchial NETs could be localised using pulmonary arterial sampling (94,95). However, generally CT, MRI and the different scintigraphy and PET techniques, as mentioned above, are more successful in the localisation of (occult) ACTH-producing extra-pituitary tumours (89,90,91,92,93). …”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

GEP-NETs update: Functional localisation and scintigraphy in neuroendocrine tumours of the gastrointestinal tract and pancreas (GEP-NETs)

Herder¹

2014

European Journal of Endocrinology

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For patients with neuroendocrine tumours (NETs) of the gastrointestinal tract and pancreas (GEP) (GEP-NETs), excellent care should ideally be provided by a multidisciplinary team of skilled health care professionals. In these patients, a combination of nuclear medicine imaging and conventional radiological imaging techniques is usually mandatory for primary tumour visualisation, tumour staging and evaluation of treatment. In specific cases, as in patients with occult insulinomas, sampling procedures can provide a clue as to where to localise the insulin-hypersecreting pancreatic NETs. Recent developments in these fields have led to an increase in the detection rate of primary GEP-NETs and their metastatic deposits. Radiopharmaceuticals targeted at specific tumour cell properties and processes can be used to provide sensitive and specific whole-body imaging. Functional imaging also allows for patient selection for receptor-based therapies and prediction of the efficacy of such therapies. Positron emission tomography/computed tomography (CT) and single-photon emission CT/CT are used to map functional images with anatomical localisations. As a result, tumour imaging and tumour follow-up strategies can be optimised for every individual GEP-NET patient. In some cases, functional imaging might give indications with regard to future tumour behaviour and prognosis.

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“…Functional imaging studies such as PET and somatostatin receptor scintigraphy (SRS) are complementary imaging tools [68][69][70]. Somatostatin receptor scintigraphy might be considered superior to PET in detecting bronchial carcinoids, especially that these tumors specifically are known to have low proliferation index [69,70]. …”

mentioning

confidence: 99%

Endocrine Paraneoplastic Syndromes: A Review

Arabi¹

2015

EMIJ

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It is important for the endocrinologist and oncologist to recognize these paraneoplastic endocrine syndromes since this may help in defining the cancer type and hence lead to the appropriate management. In addition, these syndromes are a major cause of morbidity and mortality. Moreover, AbstractParaneoplastic endocrine syndromes result from ectopic production of hormones by different tumors. Hypercalcemia of malignancy is the most common, mostly caused by ectopic parathyroid hormone related peptide (PTHrP) production which increases bone resorption. Other causes include the rare ectopic parathyroid hormone (PTH) production, ectopic production of 1, 25-(OH)2 vitamin D by the tumor and its adjacent macrophages and bone metastasis which by itself in addition to the local production of PTHrP at the level of the bone lead to bone resorption and thus hypercalcemia. Treatment includes extracellular fluid volume repletion, bisphosphonates or denosumab and calcitonin. Ectopic Cushing's syndrome caused by ectopic ACTH production results in hypokalemia, proximal muscle weakness, easy bruisability, hypertension, diabetes and psychiatric abnormalities including depression and mood disorders. Different diagnostic measures help to differentiate Cushing's disease from ectopic Cushing's syndrome. Treatment includes surgical resection of tumor and medical therapy to suppress excess cortisol production. Ectopic secretion of ADH has been associated with different tumor types. The best treatment options include removal of the underlying tumor, chemotherapy, or radiotherapy in addition to free water restriction, demeclocycline and vaptans. Ectopic growth hormone releasing hormone secretion has been identified with carcinoids, phechromocytoma and other tumors. Surgery is the mainstay of therapy with systemic therapy used in metastatic disease. Other rare ectopic hormone syndromes have also been identified including ectopic prolactin, ectopic erythropoietin, and thrombopoetin in addition to others. Keywords 2/12paraneoplastic endocrine syndromes may be the first presenting feature of malignancy [2,3]. This paper provides an overview on the common PNES, their prevalence, diagnosis, prognosis and response to treatment (Table 1). Methodology of Literature SearchEligible studies were identified by a search, from year 1920 up till February 2014, in Medline, PUBMED and EMBASE using a refined search strategy with several terms used including "endocrine paraneoplastic syndromes", "ectopic hormones", "humoral hypercalcemia of malignancy", "ectopic parathyroid hormone related peptide", "ectopic ACTH", "ectopic Cushing syndrome", "ectopic antidiuretic hormone", "syndrome of inappropriate ADH", "ectopic growth hormone releasing hormone", "ectopic growth hormone", "ectopic prolactin", "ectopic thyroid stimulating hormone" in addition to several others. In addition, searches of personal collections and the reference lists of eligible studies were identified with their full text papers being retrieved. A-Hypercalcemia of MalignancyHistorical Perspec...

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Utility of Various Functional and Anatomic Imaging Modalities for Detection of Ectopic Adrenocorticotropin-Secreting Tumors

Abstract: High sensitivity and PPV suggest thoracic CT/MRI plus LOCT scans for initial imaging, with lesion confirmation by two modalities.

Cited by 87 publications

References 21 publications

Ectopic ACTH syndrome caused by bronchial carcinoid tumor indistinguishable from Cushing's disease

Ectopic ACTH syndrome caused by bronchial carcinoid tumor indistinguishable from Cushing's disease

GEP-NETs update: Functional localisation and scintigraphy in neuroendocrine tumours of the gastrointestinal tract and pancreas (GEP-NETs)

Endocrine Paraneoplastic Syndromes: A Review

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