Cabergoline in severe ectopic or occult Cushing's syndrome

Eur J Endocrinol. 2019 Jul 1;181(1):K1-K9. doi: 10.1530/EJE-18-1014.

Abstract

Context: Cabergoline has been shown to have some effect in the treatment of moderate Cushing's disease, but its effectiveness in Cushing's syndrome of ectopic or occult origin remains to be investigated.

Case series: In this case series, cabergoline was used in combination with steroidogenesis inhibitors in nine patients with severe Cushing's syndrome of ectopic or occult origin. Cabergoline's effectiveness enabled rapid withdrawal of the steroidogenesis inhibitors and long-term control of the hypercortisolism in three of the cases.

Review of the literature: In the literature, we found only 11 cases of ectopic or occult Cushing's syndrome treated with dopamine receptor agonists, alone or in combination. Yet of these 11 cases, 10 responded.

Conclusions: Although limited, the existing experience highlights the potential value of cabergoline in the treatment of ectopic or occult Cushing's syndrome.

MeSH terms

  • ACTH Syndrome, Ectopic / complications
  • ACTH Syndrome, Ectopic / diagnosis
  • Adult
  • Aged
  • Cabergoline / therapeutic use*
  • Carcinoid Tumor / complications
  • Carcinoid Tumor / diagnostic imaging
  • Carcinoid Tumor / pathology
  • Cushing Syndrome / drug therapy*
  • Cushing Syndrome / etiology
  • Cushing Syndrome / metabolism
  • Dopamine Agonists / therapeutic use*
  • Female
  • Humans
  • Hydrocortisone / metabolism
  • Ketoconazole / therapeutic use
  • Liver Neoplasms / complications
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / pathology
  • Lung Neoplasms / complications
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Neuroendocrine Tumors / complications
  • Neuroendocrine Tumors / diagnostic imaging
  • Neuroendocrine Tumors / pathology
  • Pancreatic Intraductal Neoplasms / complications
  • Pancreatic Intraductal Neoplasms / diagnostic imaging
  • Pancreatic Intraductal Neoplasms / pathology
  • Rectal Neoplasms / complications
  • Rectal Neoplasms / diagnostic imaging
  • Rectal Neoplasms / pathology
  • Steroid Synthesis Inhibitors / therapeutic use
  • Thymus Neoplasms / complications
  • Thymus Neoplasms / diagnostic imaging
  • Thymus Neoplasms / pathology
  • Treatment Outcome

Substances

  • Dopamine Agonists
  • Steroid Synthesis Inhibitors
  • Cabergoline
  • Ketoconazole
  • Hydrocortisone