Cushing's Syndrome Caused by Ewing's Sarcoma Secreting Corticotropin Releasing Factor-Like Peptide

The corticotropin-releasing factor (CRF) family of peptides as local modulators of adrenal function

“…Cushings syndrome resulting from ectopic CRF production from several types of tumors may not be so rare as previously thought. Indeed, a growing list of tumors has been associated with ectopic CRF production high enough to cause Cushings syndrome: this list includes bronchial, thymic or mediastinal carcinoids, small cell and squamous cell carcinomas of the lung, islet cell tumors of the pancreas, medullary carcinomas of the thyroid, prostatic cancers, intrasellar choristomas and Ewings sarcomas [132][133][134][135][136][142][143][144][145][146][147][148][149]. It should be noted that at autopsy, pituitaries of these patients show nodular ACTH cell hyperplasia instead of corticotroph adenomas [145], and they are polyclonal in origin compared to the monoclonality of corticotropinomas [132].…”

Paraneoplastic Cushing syndrome because of corticotrophin-releasing hormone–secreting Wilms' tumor

“…In the pediatric population, a variety of neoplasm, including neuroblastoma [5], Ewing's sarcoma [6], malignant carcinoid tumor of the lungs [7], and thymic carcinoid tumor [8], produce one kind of cortisol, ACTH and CRH, triggering the occurrence of Cushing syndrome. Based on a survey of the literature, ACTH secretion is the most frequent cause [7,8], and CRH secretion the rarest [6]. The CRH secretion from a Wilms' tumor has not been previously reported.…”

Meningioma presenting with Cushing's syndrome: An unusual clinical presentation

“…Some tumors, however, have originated from tissues not commonly known to harbor neuroendocrine cells, for example, kidney 11 and bone. 12 Recent studies have demonstrated the synthesis of CRH outside the hypothalamus in both neuroendocrine and non neuroendocrine tissues, such as anterior pituitary, 3 skin, 13 and ovary. 14 "Ectopic" hormonal production is believed to represent cancer-induced amplification of a given cell characteristic 15 ; thus, although no evidence for CRH production by the meninges has been reported, this is likely to be the case.…”