Ectopic cushing's syndrome due to corticotropin releasing hormone

Pituitary. 2019 Oct;22(5):561-568. doi: 10.1007/s11102-019-00965-9.

Abstract

Cushing's syndrome (CS) secondary to corticotropin releasing hormone (CRH) producing tumors is rare. In this paper we present an Iranian patient who was admitted to our hospital with classic signs and symptoms of CS. Laboratory evaluation revealed high serum and urine cortisol which could not be suppressed with dexamethasone. Abdominal CT scan revealed a mass in abdominal cavity. A percutaneous needle biopsy was performed and histopathologic evaluation revealed that the mass was a neuroendocrine tumor. A multi-disciplinary approach including resection of the mass, bilateral adrenalectomy somatostatin analogue and chemotherapy was applied for management of the disease. Extensive review of English literature focusing on the topic from 1971 to 2018 revealed that there have been only 75 similar cases. Clinical, laboratory, imaging, histopathologic characteristics and managements of these patients will also be discussed in this paper.

Keywords: CRH producing tumor; Corticotropin-releasing hormone producing tumor; Cushing’s syndrome; Ectopic.

Publication types

  • Review

MeSH terms

  • Adrenalectomy
  • Corticotropin-Releasing Hormone / blood*
  • Corticotropin-Releasing Hormone / urine*
  • Cushing Syndrome / blood
  • Cushing Syndrome / drug therapy
  • Cushing Syndrome / etiology*
  • Cushing Syndrome / surgery
  • Dexamethasone / therapeutic use
  • Humans
  • Hydrocortisone / blood
  • Hydrocortisone / urine
  • Somatostatin / analogs & derivatives
  • Somatostatin / therapeutic use

Substances

  • Somatostatin
  • Dexamethasone
  • Corticotropin-Releasing Hormone
  • Hydrocortisone