A Challenging Case of an Ectopic Cushing Syndrome

Nunes, Joana; Pinho, Eva; Camões, Isabel; Bastos, Pedro; Moura, Conceição Souto; Bettencourt, Paulo

doi:10.1155/2014/413136

Cited by 6 publications

(7 citation statements)

References 31 publications

(58 reference statements)

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“…Many studies favored combination of these 2 tests in addition to tumor markers like calcitonin, chromogranin, beta-HCG, catecholamines, alpha-subunit, for accurate diagnosis. All carcinoid tumors synthetize neuropeptides such as synaptophysin, neuron-specific enolase (NSE) and chromogranins, identified by immunohistochemical markers (13). …”

Section: Discussionmentioning

confidence: 99%

“…Octreotide binds to SSTR-2 and SSTR-5 with high affinity. The expression of SSTR in bronchial carcinoid tumors has not been investigated (13). …”

Section: Discussionmentioning

confidence: 99%

“…This test has a sensitivity of 57% and positive predictive value of 79% and failed to identify tumors with negative somatostatin receptors (13). …”

Section: Discussionmentioning

confidence: 99%

“…When imaging’s failed to localize tumors, signs and symptoms are present and associated with a worse prognosis (13). …”

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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Section: Discussionmentioning

confidence: 99%

“…Octreotide binds to SSTR-2 and SSTR-5 with high affinity. The expression of SSTR in bronchial carcinoid tumors has not been investigated (13). …”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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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“…Advances in medical and surgical treatments have improved the overall survival rate for patients with ectopic ACTH [13]. Prognosis depends on primary tumor histology [14].…”

Section: Pathological Findingsmentioning

confidence: 99%

A rare ectopic ACTH secreting atypical pulmonary carcinoid- case report

Jain

Gidwani

2020

Trop J Pathol Microbiol

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Pulmonary carcinoids are rare pulmonary neoplasms which account for 1-2% of all lung neoplasms. Pulmonary carcinoid tumors are a rare cause of ectopic ACTH secretion. The incidence of Cushing's syndrome in pulmonary carcinoid tumor is approximately 1%. A case of 25-year-old young male with typical cushingoid appearance presented with headache on and off and episodes of hypertension since 1year.Thoracic CT revealed a nodular region in left lower lobe. The patient underwent left lower lobectomy and histopathology revealed an atypical carcinoid tumor. On immunohistochemistry, tumor cells were positive for CK PAN9, CD117, S100, TTF-1, synaptophysin, chromogranin and negative for P40, CK7, Her-2 and CD99.This case is presented for its rarity.

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Cushing´s syndrome: high aggressiveness of low-grade tumors

et al. 2020

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Cushing´s syndrome is caused by prolonged exposition supraphysiological to endogenous or exogenous cortisol. Ectopic production of adrenocorticotropic hormone by lung carcinoid tumors is relatively rare. Most documented cases have been reported individually. This rare neoplasm low grade that may secrete adrenocorticotropin (ACTH) leading to rapid development of hypercortisolism which is the main mode of discovery, can be a real aggressive form. This report shows a high aggressiveness of this endocrine neoplasia, wich was marked on the general, morphological, bone and psychiatric level. The trivialization of clinical signs had caused the delay in diagnosis with irreparable bone consequences.

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A Challenging Case of an Ectopic Cushing Syndrome

Cited by 6 publications

References 31 publications

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

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

A rare ectopic ACTH secreting atypical pulmonary carcinoid- case report

Cushing´s syndrome: high aggressiveness of low-grade tumors

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