Le syndrome de Cushing paranéoplasique, un vrai défi diagnostique et thérapeutique : à propos d’un cas et revue de la littérature

Meftah, A.; Moumen, A.; Hammoumi, M.M. El; Hajhouji, S.; Jadi, H. El; Guerboub, A.A.; Elmoussaoui, S.; Mayaudon, H.; Kabiri, El Hassane; Hakkou, K.; Belmejdoub, G.

doi:10.1016/j.revmed.2014.12.008

Cited by 4 publications

(9 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There have been numerous other reports of 18 F-FDG PET/CT being useful in the localization of ectopic ACTH-secreting tumors [38][39][40]. 18 F-FDG uptake shows a positive correlation with tumor cell proliferation [41].…”

Section: F-fdgmentioning

confidence: 99%

PET imaging in ectopic Cushing syndrome: a systematic review

et al. 2015

View full text Add to dashboard Cite

Cushing syndrome due to endogenous hypercortisolism may cause significant morbidity and mortality. The source of excess cortisol may be adrenal, pituitary, or ectopic. Ectopic Cushing syndrome is sometimes difficult to localize on conventional imaging like CT and MRI. After performing a multilevel thoracoabdominal imaging with CT, the evidence regarding the use of radiotracers for PET imaging is unclear due to significant molecular and etiological heterogeneity of potential causes of ectopic Cushing's syndrome. In our systematic review of literature, it appears that GalLium-based (Ga68) somatostatin receptor analogs have better sensitivity in diagnosis of bronchial carcinoids causing Cushing syndrome and FDG PET appears superior for small-cell lung cancers and other aggressive tumors. Further large-scale studies are needed to identify the best PET tracer for this condition.

show abstract

Section: F-fdgmentioning

confidence: 99%

PET imaging in ectopic Cushing syndrome: a systematic review

et al. 2015

View full text Add to dashboard Cite

show abstract

“…ECS affects females as well as males equally, whereas Cushing disease affects more young female (14). …”

Section: Discussionmentioning

confidence: 99%

“…FDG-PET scan identifies small metabolically active lesions with a sensitivity of 64% and positive predictive value of 53% for occult disease, as well as F-Fluorine-18-dixydroxy-phenylalanine (F-DOPA) PET scan which is more appropriate for later stages in undifferentiated neuroendocrine tumors (6, 14). Our last case failed to show the primary tumor origin and other imaging’s are unavailable in our institution.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical resection of the primary tumor with lymphadenectomy is beneficial when performed for localized tumors, but it is often impossible in the advanced setting (4, 14). …”

Section: Discussionmentioning

confidence: 99%

“…Done laparoscopically, it carries low mortality and morbidity with a successful rate of 100% if done by expert surgeons in non-critically ill patients, especially if there is severe hypercortisolism altering prognosis and ineffective medical treatment (6, 14). …”

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

View full text Add to dashboard Cite

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.

show abstract