Cushing's syndrome due to ectopic ACTH secretion.

Cushing's syndrome due to ectopic ACTH secretion. Endokrynol Pol. 2016 Jul 8; Authors: Cieszyński Ł, Obołończyk MB, Szulc M, Sworczak K Abstract Cushing's syndrome (CS) is defined as a constellation of clinical signs and symptoms occurring due to hypercortisolism. Cortisol excess may be endogenous or exogenous. The most common cause of CS is glucocorticoid therapy with supraphysiological (higher than in case of substitution) doses used in various diseases (eg. Autoimmune). One of possible CS causes is ectopic (extra-pituitary) ACTH secretion, by benign or malignant tumors. The first description of ectopic ACTH secretion (EAS) was proposed by Liddle in 1963; it based mainly on patients with small cell lung cancer (SCLC). Since that time EAS etiology has changed, i.e. apart from SCLC higher incidence of other malignancies has been reported. EAS symptoms are usually similar to hypercortisolism symptoms due to other causes. A clinical suspicion of CS requires laboratory investigations. There is no single and specific laboratory test for making a CS diagnosis and therefore multiple dynamic tests should be ordered. Combination of multiple laboratory noninvasive and invasive tests allows for achieving a 100% sensitivity and a 98% specificity for EAS diagnosis. If the EAS causing malignancy is diagnosed as a localised disease surgery is the optimal treatment choice. Radical tumor excision may be performed in 40% of patients and 80% of th...
Source: Endokrynologia Polska - Category: Endocrinology Authors: Tags: Endokrynol Pol Source Type: research