Cushing's syndrome associated with ectopic corticotropin production and small-cell lung cancer.

Shepherd, Frances A.; Laskey, Jennifer; Evans, William K.; Goss, Paul E.; Johansen, Else; Khamsi, Firouz

doi:10.1200/jco.1992.10.1.21

Cited by 125 publications

(88 citation statements)

References 16 publications

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“…Cortisol was determined to evaluate adrenal function and possible ectopic cortisol production that could be observed in SCLC (Shepherd et al, 1992; Collichio et al, 1994). Cortisol was measured with a radioimmunoassay.…”

Section: Biochemical Parametersmentioning

confidence: 99%

The effects of treatment with chemotherapy on energy metabolism and inflammatory mediators in small-cell lung carcinoma

Aj¹,

Schols²,

Ma³

et al. 1997

Br J Cancer

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Summary A disturbed energy balance has been demonstrated in lung cancer patients. Both an enhanced resting energy expenditure (REE) and a decreased energy intake contribute to weight loss. Enhanced systemic levels of inflammatory mediators were found to be related to the enhanced REE in lung cancer. The aim of the present study was to investigate energy metabolism and systemic levels of inflammatory mediators in small-cell lung carcinoma (SCLC) patients before and after treatment with chemotherapy. Hypermetabolism and an enhanced inflammatory response have already been demonstrated in SCLC by our group before. Twelve newly diagnosed SCLC patients were consecutively included in the study. REE was measured by indirect calorimetry and body composition was determined by bioelectrical impedance (BIA) before and 1 month after treatment. To assess the inflammatory state the acute-phase proteins, C-reactive protein (CRP) and lipopolysaccharide-binding protein (LBP), both soluble tumour necrosis factor (TNF) receptors, (sTNF-R)-55 and sTNF-R75, and soluble intercellular adhesion molecule (slCAM)-1 were measured in plasma before and 1 month after treatment. CRP was assessed by turbidemetry, whereas the other inflammatory parameters were measured by enzyme-linked immunosorbent assay (ELISA). A significant reduction in REE was found irrespective of therapeutic outcome, whereas body weight and body composition remained stable. The acute-phase proteins CRP and LBP were reduced significantly after treatment with chemotherapy, whereas both sTNF receptors and sICAM-1 remained enhanced. No correlation, however, existed between the decrease in REE and the decrease in the acute-phase proteins. In conclusion, chemotherapeutic treatment attenuates the tumour-related metabolic derangements and acute-phase response.Keywords: small-cell lung cancer; inflammation; resting energy expenditure; weight loss; acute-phase response Weight loss is a frequently occurring problem in lung cancer patients. Severe weight loss (2 10% weight loss) has been found in 30% of patients with newly detected lung cancer (Staal et al, 1994). Both an increased resting energy expenditure (REE) and a decreased energy intake contribute to weight loss in lung cancer patients (Russell et al, 1984;Hansell et al, 1986; Fredrix et al, 1991;Staal et al, 1994). Apart from body composition, the localization of the tumour in the central airways and enhanced systemic levels of inflammatory mediators were found to be determining factors of an increased REE in lung cancer patients (Staal et al, 1994;. The involvement of inflammatory mediators in metabolic derangements has been demonstrated in experimental animal studies as well as in oncological patients with different tumour types (Fong et al, 1989; Denz et al, 1993; Falconer et al, 1994;Staal et al, 1995).In addition to general tumour characteristics, histology has to be considered as a factor related to energy metabolism in lung cancer patients. Lung cancer can be divided into small-cell lung carcinoma (SCLC) and non-small...

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Section: Biochemical Parametersmentioning

confidence: 99%

The effects of treatment with chemotherapy on energy metabolism and inflammatory mediators in small-cell lung carcinoma

Aj¹,

Schols²,

Ma³

et al. 1997

Br J Cancer

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“…Neuroendocrine tumors (NETs), mainly bronchial carcinoids (BC) (3-54.8%), are the most frequent causes of ectopic ACTH secretion in more recent series (3,4,5,6,7,8), whereas small-cell lung carcinoma (SCLC) represented the most common tumor associated with ECS in early series (3.3-50%) (9). Other less-frequent causes are thymic carcinoids (TC) (5-42%), pancreatic (p) NETs (7.5-25%), pheochromocytomas (2.5-25%) and medullary thyroid carcinomas (MTC) (2-8%) (3,4,5,6,7,8).…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors in ectopic Cushing’s syndrome due to neuroendocrine tumors: a multicenter study

Davì

Cosaro

Piacentini

et al. 2017

European Journal of Endocrinology

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Objective: Evidence is limited regarding outcome of patients with ectopic Cushing's syndrome (ECS) due to neuroendocrine tumors (NETs). Design: We assessed the prognostic factors affecting the survival of patients with NETs and ECS. Methods: Retrospective analysis of clinicopathological features, severity of hormonal syndrome, treatments from a large cohort of patients with NETs and ECS collected from 17 Italian centers. Results: Our series included 110 patients, 58.2% female, with mean (±s.d.) age at diagnosis of 49.5 ± 15.9 years. The main sources of ectopic ACTH were bronchial carcinoids (BC) (40.9%), occult tumors (22.7%) and pancreatic (p)NETs (15.5%). Curative surgery was performed in 56.7% (70.2% of BC, 11% of pNETs). Overall survival was significantly higher in BC compared with pNETs and occult tumors (P = 0.033) and in G1-NETs compared with G2 and G3 (P = 0.007). Negative predictive factors for survival were severity of hypercortisolism (P < 0.02), hypokalemia (P = 0.001), diabetes mellitus (P = 0.0146) and distant metastases (P < 0.001). Improved survival was observed in patients who underwent NET removal (P < 0.001). Adrenalectomy improved short-term survival. Clinical Study

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“…There are several reports about the complications of chemotherapy in patients with ectopic ACTH-production. The com-plications reported are mostly related to severe infections and gastrointestinal bleeding or ulceration [10,11]. A small study of Dimopoulos et al [12] reported nine out of 11 patients with SCLC and paraneoplastic Cushing's syndrome to decease within two weeks after onset of chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…A small study of Dimopoulos et al [12] reported nine out of 11 patients with SCLC and paraneoplastic Cushing's syndrome to decease within two weeks after onset of chemotherapy. Shepherd et al [11] found that ectopic ACTHproduction is associated with a low response to chemotherapy, short survival and a high rate of complication.…”

Section: Discussionmentioning

confidence: 99%

A case of recurrent non-small-cell lung carcinoma and paraneoplastic Cushing's syndrome

et al. 2006

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Summary Secretion of ectopic adrenocorticotropic hormone (ACTH) with consequently Cushing's syndrome is a rare paraneoplastic phenomenon. It has been described in a variety of malignancies, like bronchial carcinoids, small-cell lung carcinoma, thymoma, pancreatic carcinoma and other. In many cases of suspected ectopic ACTH secretion, it is difficult to histologically or cytochemically confirm the diagnosis. We present a 63-year-old woman with a recurrent poorly differentiated squamous cell lung carcinoma with clinical and biochemical features consistent with ectopic Cushing's syndrome. Immunocytochemical staining confirmed the secretion of ACTH by tumour cells.

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Cushing's syndrome associated with ectopic corticotropin production and small-cell lung cancer.

Abstract: Ectopic ACTH production is associated with a low response to chemotherapy, short survival, and a high rate of complication to therapy.

Cited by 125 publications

References 16 publications

The effects of treatment with chemotherapy on energy metabolism and inflammatory mediators in small-cell lung carcinoma

The effects of treatment with chemotherapy on energy metabolism and inflammatory mediators in small-cell lung carcinoma

Prognostic factors in ectopic Cushing’s syndrome due to neuroendocrine tumors: a multicenter study

A case of recurrent non-small-cell lung carcinoma and paraneoplastic Cushing's syndrome

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