Ectopic ACTH syndrome caused by a bronchial carcinoid tumor responsive to dexamethasone, metyrapone, and corticotropin-releasing factor. 1988

C D Malchoff, and D N Orth, and C Abboud, and J A Carney, and P C Pairolero, and R M Carey
Department of Medicine, University of Virginia Medical Center, Charlottesville 22901.

Cushing's syndrome due to bronchial carcinoid tumors that secrete adrenocorticotropin (ACTH) may be difficult to distinguish from pituitary Cushing's disease, since the responses to dexamethasone and metyrapone are sometimes similar. Recently, the ACTH and cortisol responses to ovine corticotropin-releasing factor (oCRF) have been shown to be different in pituitary Cushing's disease than in Cushing's syndrome due to other causes. It is not known if the response to oCRF can distinguish pituitary Cushing's disease from those ACTH-secreting bronchial carcinoid tumors that respond to dexamethasone and metyrapone. A case of Cushing's syndrome due to an ACTH-secreting bronchial carcinoid is described in which the responses to dexamethasone, metyrapone, and oCRF were indistinguishable from the responses observed in pituitary Cushing's disease. A bronchial carcinoid tumor should be considered even when responses to dexamethasone, metyrapone, and oCRF suggest pituitary Cushing's disease.

UI MeSH Term Description Entries
D008797 Metyrapone An inhibitor of the enzyme STEROID 11-BETA-MONOOXYGENASE. It is used as a test of the feedback hypothalamic-pituitary mechanism in the diagnosis of CUSHING SYNDROME. Methbipyranone,Methopyrapone,Metopiron,Metopirone,Métopirone,SU 4885
D009384 Paraneoplastic Endocrine Syndromes Syndromes resulting from inappropriate production of HORMONES or hormone-like materials by NEOPLASMS in non-endocrine tissues or not by the usual ENDOCRINE GLANDS. Such hormone outputs are called ectopic hormone (HORMONES, ECTOPIC) secretion. Ectopic Hormone Syndromes,Ectopic Hormone Syndrome,Endocrine Syndrome, Paraneoplastic,Paraneoplastic Endocrine Syndrome,Syndrome, Ectopic Hormone,Syndrome, Paraneoplastic Endocrine,Syndromes, Ectopic Hormone,Syndromes, Paraneoplastic Endocrine
D001984 Bronchial Neoplasms Tumors or cancer of the BRONCHI. Neoplasms, Bronchial,Bronchial Neoplasm,Neoplasm, Bronchial
D002276 Carcinoid Tumor A usually small, slow-growing neoplasm composed of islands of rounded, oxyphilic, or spindle-shaped cells of medium size, with moderately small vesicular nuclei, and covered by intact mucosa with a yellow cut surface. The tumor can occur anywhere in the gastrointestinal tract (and in the lungs and other sites); approximately 90% arise in the appendix. It is now established that these tumors are of neuroendocrine origin and derive from a primitive stem cell. (From Stedman, 25th ed & Holland et al., Cancer Medicine, 3d ed, p1182) Argentaffinoma,Carcinoid,Carcinoid, Goblet Cell,Argentaffinomas,Carcinoid Tumors,Carcinoids,Carcinoids, Goblet Cell,Goblet Cell Carcinoid,Goblet Cell Carcinoids,Tumor, Carcinoid,Tumors, Carcinoid
D003346 Corticotropin-Releasing Hormone A peptide of about 41 amino acids that stimulates the release of ADRENOCORTICOTROPIC HORMONE. CRH is synthesized by neurons in the PARAVENTRICULAR NUCLEUS of the HYPOTHALAMUS. After being released into the pituitary portal circulation, CRH stimulates the release of ACTH from the PITUITARY GLAND. CRH can also be synthesized in other tissues, such as PLACENTA; ADRENAL MEDULLA; and TESTIS. ACTH-Releasing Hormone,CRF-41,Corticotropin-Releasing Factor,Corticotropin-Releasing Hormone-41,ACTH-Releasing Factor,CRF (ACTH),Corticoliberin,Corticotropin-Releasing Factor-41,ACTH Releasing Factor,ACTH Releasing Hormone,Corticotropin Releasing Factor,Corticotropin Releasing Factor 41,Corticotropin Releasing Hormone,Corticotropin Releasing Hormone 41
D003480 Cushing Syndrome A condition caused by prolonged exposure to excess levels of cortisol (HYDROCORTISONE) or other GLUCOCORTICOIDS from endogenous or exogenous sources. It is characterized by upper body OBESITY; OSTEOPOROSIS; HYPERTENSION; DIABETES MELLITUS; HIRSUTISM; AMENORRHEA; and excess body fluid. Endogenous Cushing syndrome or spontaneous hypercortisolism is divided into two groups, those due to an excess of ADRENOCORTICOTROPIN and those that are ACTH-independent. Cushing's Syndrome,Hypercortisolism,Syndrome, Cushing,Syndrome, Cushing's
D003907 Dexamethasone An anti-inflammatory 9-fluoro-glucocorticoid. Hexadecadrol,Decaject,Decaject-L.A.,Decameth,Decaspray,Dexasone,Dexpak,Hexadrol,Maxidex,Methylfluorprednisolone,Millicorten,Oradexon,Decaject L.A.
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006854 Hydrocortisone The main glucocorticoid secreted by the ADRENAL CORTEX. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions. Cortef,Cortisol,Pregn-4-ene-3,20-dione, 11,17,21-trihydroxy-, (11beta)-,11-Epicortisol,Cortifair,Cortril,Epicortisol,Hydrocortisone, (11 alpha)-Isomer,Hydrocortisone, (9 beta,10 alpha,11 alpha)-Isomer,11 Epicortisol

Related Publications

C D Malchoff, and D N Orth, and C Abboud, and J A Carney, and P C Pairolero, and R M Carey
November 1989, Zhonghua nei ke za zhi,
C D Malchoff, and D N Orth, and C Abboud, and J A Carney, and P C Pairolero, and R M Carey
January 2010, Endocrine journal,
C D Malchoff, and D N Orth, and C Abboud, and J A Carney, and P C Pairolero, and R M Carey
August 1985, Endocrinologia japonica,
C D Malchoff, and D N Orth, and C Abboud, and J A Carney, and P C Pairolero, and R M Carey
February 2004, Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine,
C D Malchoff, and D N Orth, and C Abboud, and J A Carney, and P C Pairolero, and R M Carey
July 2009, Clinical nuclear medicine,
C D Malchoff, and D N Orth, and C Abboud, and J A Carney, and P C Pairolero, and R M Carey
January 2015, Endocrine journal,
C D Malchoff, and D N Orth, and C Abboud, and J A Carney, and P C Pairolero, and R M Carey
June 2001, Clinical endocrinology,
C D Malchoff, and D N Orth, and C Abboud, and J A Carney, and P C Pairolero, and R M Carey
April 2011, The Thoracic and cardiovascular surgeon,
C D Malchoff, and D N Orth, and C Abboud, and J A Carney, and P C Pairolero, and R M Carey
January 2002, Acta clinica Belgica,
C D Malchoff, and D N Orth, and C Abboud, and J A Carney, and P C Pairolero, and R M Carey
June 1998, Indian journal of cancer,
Copied contents to your clipboard!