Abstract
We report on a case of ectopic Cushing's syndrome due to a thymic carcinoid tumour with periodic hormonogenesis. Periods of hormonal production averaged 27 days. Prior to bilateral adrenalectomy, mean (s.d) values of ACTH and cortisol were 202.1 (50.3) pg/ml and 46 (14.7) micrograms/dl, ACTH rising to 3996 +/- 425 pg/ml (P less than 0.01) and cortisol falling to 6.3 +/- 1.5 micrograms/dl (P less than 0.01) in the immediate postoperative period. During the late postoperative period (2-13 months following surgery) ACTH levels fell to 509.3 (123.8) pg/ml (P less than 0.01), but remaining even higher (P less than 0.01) than before adrenalectomy. The pattern of ACTH in the present case suggests the existence of a negative feedback exerted by the cortisol over tumoral ACTH.
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- Bailey R. E. Periodic hormonogenesis--a new phenomenon. Periodicity in function of a hormone-producing tumor in man. J Clin Endocrinol Metab. 1971 Mar;32(3):317–327. doi: 10.1210/jcem-32-3-317. [DOI] [PubMed] [Google Scholar]
- Brown R. D., Van Loon G. R., Orth D. N., Liddle G. W. Cushing's disease with periodic hormonogenesis: one explanation for paradoxical response to dexamethasone. J Clin Endocrinol Metab. 1973 Mar;36(3):445–451. doi: 10.1210/jcem-36-3-445. [DOI] [PubMed] [Google Scholar]
- Chajek T., Romanoff H. Cushing syndrome with cyclical edema and periodic secretion of corticosteroids. Arch Intern Med. 1976 Apr;136(4):441–443. [PubMed] [Google Scholar]
- Corrigan D. F., Schaaf M., Whaley R. A., Czerwinski C. L., Earll J. M. Selective venous sampling to differentiate ectopic ACTH secretion from pituitary Cushing's syndrome. N Engl J Med. 1977 Apr 14;296(15):861–862. doi: 10.1056/NEJM197704142961508. [DOI] [PubMed] [Google Scholar]
- French F. S., Macfie J. A., Baggett B., Williams T. F., Van Wyk J. J. Cushing's syndrome with a paradoxical response to dexamethasone. Am J Med. 1969 Oct;47(4):619–624. doi: 10.1016/0002-9343(69)90191-0. [DOI] [PubMed] [Google Scholar]
- Green J. R., van't Hoff W. Cushing's syndrome with fluctuation due to adrenal adenoma. J Clin Endocrinol Metab. 1975 Aug;41(2):235–240. doi: 10.1210/jcem-41-2-235. [DOI] [PubMed] [Google Scholar]
- Liberman B., Wajchenberg B. L., Tambascia M. A., Mesquita C. H. Periodic remission in Cushing's disease with paradoxical dexamethasone response: an expression of periodic hormonogenesis. J Clin Endocrinol Metab. 1976 Oct;43(4):913–918. doi: 10.1210/jcem-43-4-913. [DOI] [PubMed] [Google Scholar]
- Pimstone B. L., Uys C. J., Vogelpoel L. Studies in a case of Cushing's syndrome due to an ACTH-producing thymic tumour. Am J Med. 1972 Oct;53(4):521–528. doi: 10.1016/0002-9343(72)90149-0. [DOI] [PubMed] [Google Scholar]
- Schweikert H. U., Fehm H. L., Fahlbusch R., Martin R., Kolloch R., Higuchi M., Krück F. Cyclic Cushing's syndrome combined with cortisol suppressible, dexamethasone non-suppressible ACTH secretion: a new variant of Cushing's syndrome. Acta Endocrinol (Copenh) 1985 Nov;110(3):289–295. doi: 10.1530/acta.0.1100289. [DOI] [PubMed] [Google Scholar]
- Thorner M. O., Martin W. H., Ragan G. E., MacLeod R. M., Feldman P. S., Bruni C., Williamson B. R., Orth D. N. A case of ectopic ACTH syndrome: diagnostic difficulties caused by intermittent hormone secretion. Acta Endocrinol (Copenh) 1982 Mar;99(3):364–370. doi: 10.1530/acta.0.0990364. [DOI] [PubMed] [Google Scholar]