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[Paraneoplastic hypercorticism].

J P Luton, X Bertagna, B Guilhaume

    Annales De Medecine Interne
    |January 1, 1984
    PubMed
    Summary
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    Paraneoplastic hypercorticism, caused by ectopic adrenocorticotropic hormone (ACTH) secretion, is often missed due to subtle Cushing's disease symptoms. Early diagnosis and treatment with anticortisol drugs can improve survival for patients with difficult-to-treat primary tumors.

    Area of Science:

    • Endocrinology
    • Oncology
    • Internal Medicine

    Background:

    • Paraneoplastic hypercorticism arises from ectopic secretion of corticotropin-releasing hormone (CRH) or ACTH.
    • The condition's incidence is underestimated due to latent clinical presentations of Cushing's disease.
    • Primary tumors (e.g., bronchopulmonary, thymic, pancreatic) may present late, complicating diagnosis.

    Purpose of the Study:

    • To highlight the diagnostic challenges of paraneoplastic hypercorticism.
    • To discuss the utility of hormonal markers in diagnosis.
    • To explore therapeutic strategies for improving patient survival.

    Main Methods:

    • Review of clinical cases and diagnostic approaches for ectopic ACTH syndrome.
    • Analysis of hormonal assays, including ACTH and lipotropic hormone (LPH) measurements.

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  • Evaluation of novel markers for ectopic hormone secretion.

    • Main Results:

    • Variability in hormonal secretion complicates dynamic testing interpretation.
    • ACTH and LPH measurements are valuable diagnostic tools.
    • Emerging specific markers show promise for identifying ectopic secretion.

    Conclusions:

    • Paraneoplastic hypercorticism requires heightened clinical suspicion due to its often-subtle presentation.
    • Accurate diagnosis relies on careful interpretation of hormonal assays and consideration of novel markers.
    • Management focuses on treating the primary tumor or, when not feasible, using anticortisol drugs to improve survival and quality of life.