Successful treatment with SMS 201-995 of Cushing's syndrome caused by ectopic adrenocorticotropin secretion from a metastatic gastrin-secreting pancreatic islet cell carcinoma.

Abstract

Signs and symptoms of Cushing's syndrome developed rapidly after total gastrectomy in a 37-yr-old man with a metastatic gastrin-secreting islet cell carcinoma. Argyrophilic tumor cells in a lymph node removed during operation immunostained for gastrin and ACTH. Treatment for more than 6 months with the somatostatin analog SMS 201-995 (300 micrograms/day) greatly reduced serum gastrin levels and normalized plasma ACTH and cortisol levels and urinary cortisol excretion, and the signs and symptoms of Cushing's syndrome disappeared. The size of the primary tumor in the head of the pancreas, which had grown rapidly before SMS 201-995 therapy, stabilized after 6 months of treatment with the analog. We conclude that SMS 201-995 can reduce ACTH as well as gastrin secretion from islet cell carcinomas as well as control tumor growth.

• Authors: S W Lamberts, H W Tilanus, A I Klooswijk, H A Bruining, A J van der Lely, F H de Jong
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 67 Issue 5 Pg. 1080-3 (Nov 1988) ISSN: 0021-972X [Print] United States
• PMID: 2846625 (Publication Type: Case Reports, Journal Article)

Chemical References

• Gastrins
• Hormones, Ectopic
• Adrenocorticotropic Hormone
• Octreotide
• Hydrocortisone

Topics

• Adenoma, Islet Cell (metabolism)
• Adrenocorticotropic Hormone (metabolism)
• Adult
• Cushing Syndrome (blood, drug therapy, etiology)
• Gastrins (blood, metabolism)
• Hormones, Ectopic (metabolism)
• Humans
• Hydrocortisone (blood)
• Male
• Neoplasm Metastasis
• Octreotide (therapeutic use)
• Pancreatic Neoplasms (metabolism)