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[Cushing syndrome due to ectopic ACTH secretion].

B B Mendonça, G Madureira, W Bloise

    Revista Paulista De Medicina
    |January 1, 1989
    PubMed
    Summary
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    Ectopic ACTH secretion causing Cushing's syndrome can present atypically. Imaging like thoracic X-rays and CT scans are crucial for diagnosing ectopic ACTH tumors in Cushing's syndrome.

    Area of Science:

    • Endocrinology
    • Oncology
    • Radiology

    Background:

    • Cushing's syndrome is characterized by excess cortisol.
    • Ectopic ACTH secretion is a rare cause of Cushing's syndrome.
    • Diagnosis can be challenging due to overlapping clinical and hormonal features.

    Purpose of the Study:

    • To analyze clinical and diagnostic features of Cushing's syndrome caused by ectopic ACTH secretion.
    • To highlight the importance of imaging in identifying ectopic ACTH-producing tumors.

    Main Methods:

    • Retrospective analysis of 8 patients with ectopic ACTH secretion.
    • Clinical evaluation, hormonal assays (cortisol, ACTH), and imaging studies (X-ray, CT scan).

    Main Results:

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  • Patients exhibited typical Cushing's signs, hypertension, and hypokalemia.
  • Hormonal profiles and dexamethasone suppression tests were sometimes misleading.
  • Tumors identified included carcinoids, islet cell tumors, pheochromocytomas, and oat cell carcinoma.
  • Imaging (thoracic X-ray, CT) was vital for tumor localization.

    • Conclusions:

    • Clinical and hormonal findings may not definitively distinguish ectopic ACTH secretion from Cushing's disease.
    • Comprehensive imaging of the skull, thorax, and abdomen is recommended for all Cushing's syndrome cases.
    • Early diagnosis and localization of ectopic ACTH sources are critical, given the poor prognosis.