Occult ectopic secretion of corticotropin. Arch Intern Med 1986 May;146(5):929-33
Date
05/01/1986Pubmed ID
3963984DOI
10.1001/archinte.1986.00360170151022Scopus ID
2-s2.0-0022641618 (requires institutional sign-in at Scopus site) 123 CitationsAbstract
The clinical, biochemical, radiographic, and morphologic features of ectopic corticotropin (ACTH)-dependent Cushing's syndrome are often indistinguishable from those of Cushing's disease (pituitary-dependent Cushing's syndrome). We encountered ten patients whose ectopic ACTH-secreting neoplasms were not clinically apparent for two months to 12 years after the diagnosis of hypercortisolism or in whom the site remains unknown. Five of these patients underwent unnecessary pituitary microsurgery, and a sixth was referred for surgery. The occult ectopic ACTH syndrome occurs with equal frequency in men and women and hypokalemia is present in 60%, in contrast to the female predominance and rarity of hypokalemia in Cushing's disease. We emphasize the importance of selective venous sampling for ACTH to establish the correct diagnosis. Thirty-nine similar cases from the literature help characterize this syndrome further.
Author List
Findling JW, Tyrrell JBAuthor
James W. Findling MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
ACTH Syndrome, EctopicAdrenal Cortex
Adult
Aged
Carcinoid Tumor
Cushing Syndrome
Diagnosis, Differential
Female
Humans
Hyperplasia
Hypokalemia
Lung Neoplasms
Male
Middle Aged
Pancreatic Neoplasms
Paraneoplastic Endocrine Syndromes
Pituitary Neoplasms
