Ectopic ACTH Syndrome

04/01/2012 - "Inferior petrosal sinus sampling (IPSS) for ACTH is the current gold standard test for the differentiation of pituitary Cushing's disease from the ectopic ACTH syndrome. "
04/01/2004 - "The study group included 35 patients: 32 with pituitary-dependent CS (positive immunohistochemical findings for ACTH pituitary tumour or biochemical cure after pituitary surgery) and three with histologically proven ectopic ACTH syndrome. "
04/01/2015 - "We suggest the use of 68Ga DOTANOC PET/CT as a first-line imaging modality for localization of source of ACTH secretion in ectopic ACTH syndrome."
09/01/2013 - "Dark pigmentation gradually developed on her skin and her serum adrenocorticotropic hormone (ACTH) was high, suggesting concurrent ectopic ACTH syndrome (EAS). "
01/01/2013 - "Four patients with Cushing's disease and 2 patients with ectopic ACTH syndrome had IJV: Peripheral vein ACTH ratio less than 1.6. "

01/01/2004 - "In most, but not all, patients with ectopic ACTH syndrome, cortisol is unresponsive to high-dose dexamethason suppression test, what is used as diagnostic tool. "
05/01/1992 - "Two measures of the peripheral metabolism of cortisol were found to be markedly decreased in two patients with the ectopic ACTH syndrome. "
08/01/1991 - "In 18 patients with the ectopic ACTH-syndrome the 'mean cortisol levels', obtained from five or six samples on the test day (median 1023 nmol/l, range 823-6354) were reduced to less than 400 nmol/l in 13 patients (70%), on a median dose of 4000 mg/day (range 1000-6000). "
01/01/2013 - "Thorax is the most common location of causative lesions for ectopic ACTH syndrome, and the size of lesion is too small to be detected in some cases.1, 2 Cryptococcal pneumonia usually occurs in immunocompromised patients and excess cortisol production can theoretically produce a state of immunodeficiency. "
03/01/2004 - "There were 80 patients with Cushing's disease (78%), 13 with the ectopic ACTH syndrome (13%), and 10 with cortisol-producing adrenocortical adenomas (10%). "

05/01/1989 - "These data indicate that octreotide can be a highly effective treatment for patients with the ectopic ACTH syndrome."
09/01/2006 - "In situations when conventional imaging is not conclusive, octreotide scanning may be of help in determining the source of ectopic ACTH syndrome."
11/01/1999 - "Octreotide scintigraphy may be considered in patients with suspicion of ectopic ACTH syndrome although a positive image in CT scan be present."
02/01/1999 - "Carcinoid-associated ectopic ACTH syndrome with variable response to octreotide."
12/01/1995 - "We report a 40-year-old patient with the ectopic ACTH syndrome due to a 0.6-cm bronchial carcinoid tumour which was successfully localized by 111indium-DTPA labelled octreotide scintigraphy."

01/01/1994 - "Somatostatin radioanalog scintigraphy should be considered as a new investigative tool in patients with suspected ectopic ACTH syndrome."
06/01/1991 - "Among the results of other endocrinological examinations conducted to find the etiological cause of the hyperglycemic coma, which seemed to be unusual for ectopic ACTH syndrome, the plasma somatostatin level was abnormally high. "
01/01/1993 - "We report on the efficacy of the long-acting somatostatin analog octreotide in a 43-yr old woman with ectopic ACTH syndrome. "
05/01/1989 - "The long-acting somatostatin analog (octreotide) was administered to a 37-yr-old woman with the ectopic ACTH syndrome. "
03/01/1990 - "In this study we investigated the effects of somatostatin or octreotide on ACTH levels of patients with corticotropin hypersecretion: 7 patients with Addison's disease, 2 patients previously adrenalectomized for Cushing's disease, 4 patients with Cushing's disease and 3 patients with ectopic ACTH syndrome. "

09/01/2008 - "Ectopic ACTH syndrome was confirmed leading to ketoconazole treatment. "
01/01/1991 - "On the contrary, in ectopic ACTH syndrome, this aim can be impossible to reach with ketoconazole although the reasons for its ineffectiveness remain to be determined."
01/01/1991 - "Patients with ectopic ACTH syndrome received 1200 mg ketoconazole per day for at least 2 months. "
01/01/1991 - "We have used ketoconazole in eight patients: four patients with Cushing's disease, two patients with overt and two with occult ectopic ACTH syndrome. "
01/01/1991 - "Few data are available about the use of ketoconazole in the management of the ectopic ACTH syndrome. "

06/01/2003 - "Differentiating between Cushing's disease of pituitary origin and ectopic ACTH syndrome of extra-pituitary origin remains a major challenge to the clinician because of limitations in the diagnostic accuracy of the high-dose dexamethasone suppression test. "
02/01/1983 - "A case of dexamethasone non-suppressible Cushing's disease hardly differentiated from ectopic ACTH syndrome."
10/23/1982 - "In spite of the presence of an ectopic ACTH syndrome, the clinical, radiological and biochemical findings and the positive dexamethasone suppression test were compatible with Cushing's disease. "
01/01/1996 - "The efficacy of a nocturnal 8 mg dexamethasone suppression test (nocturnal DST) was compared with that of the standard high-dose dexamethasone suppression test (standard DST) in identifying the cause of endogenous Cushing's syndrome in 10 proven cases with Cushing's disease, 20 with adrenal tumours, and one with ectopic ACTH syndrome. "
06/01/1985 - "Seventeen patients with well-proven Cushing's syndrome (13 with Cushing's disease, 3 with adrenal tumour and 1 presenting ectopic ACTH syndrome caused by bronchial carcinoid) were investigated by using a single-dose 8 mg dexamethasone nocturnal test. "

01/01/2015 - "Ectopic ACTH syndrome caused by desmopressin-responsive thymic neuroendocrine tumor."
10/01/1997 - "In conclusion, the DDAVP stimulation test, i.e., determination of plasma ACTH levels after 5 microg DDAVP injection, seems useful for discriminating Cushing's disease from normality, and may serve to facilitate the differentiation between Cushing's disease and ectopic ACTH syndrome."
05/01/1993 - "Eight patients with adrenal tumours and one with the ectopic ACTH syndrome did not respond to desmopressin, having shown changes in their cortisol levels from -5 to 42% above baseline. "
10/01/1997 - "After an intravenous injection of 5 microg DDAVP, plasma ACTH levels increased to more than 200% of the basal levels in 10 of 10 patients with Cushing's disease, but remained less than 150% in all of 11 normal subjects, 3 patients with Addison's disease, 5 cases of Cushing's disease in remission, and 3 patients with ectopic ACTH syndrome. "
06/01/1997 - "Plasma ACTH and serum cortisol levels were evaluated after the administration of desmopressin (10 micrograms i.v.), CRH (1 microgram/kg i.v.) and saline on different days in 17 patients with Cushing's disease, 1 with occult ectopic ACTH syndrome, 5 with Addison's disease, 3 who had been bilaterally adrenalectomized for Cushing's syndrome and 4 normal subjects. "

04/01/1994 - "Somatostatin receptor scintigraphy and the ectopic ACTH syndrome--the solution or just another test?"
01/01/2002 - "Ectopic ACTH syndrome: discrepancy between somatostatin receptor status in vivo and ex vivo, and between immunostaining and gene transcription for POMC and CRH."
02/01/2012 - "This case report demonstrates the management of ectopic ACTH-syndrome by molecularly -targeted therapy with dopamine receptor -agonists as well as improved detection of the ectopic ACTH source by novel imaging modalities, such as [(68)Ga-DOTA]-TATE PET specifically targeting somatostatin receptor subtype-2 with high affinity."
10/01/2006 - "We concluded that: 1) measurement of late-night or bedtime salivary cortisol is a useful approach to screen for Cushing's syndrome; 2) measurement of suppressed plasma ACTH by immunometric assay is useful to differentiate ACTH-dependent and -independent Cushing's syndrome; 3) inferior petrosal sinus sampling for ACTH should be performed in patients with ACTH-dependent hypercortisolism in whom a pituitary magnetic resonance imaging is normal or equivocal (in the absence of a pituitary ACTH gradient, prolactin levels should be measured to confirm the integrity of venous sampling); 4) computed tomography of the chest and abdomen and somatostatin receptor scintigraphy should be performed in patients with the occult ectopic ACTH syndrome; and 5) patients with Cushing's disease should be referred to a neurosurgeon with extensive experience operating on corticotroph microadenomas. "

01/01/2014 - "A case of ectopic ACTH syndrome treated with intermittent administration of dopamine agonists."
01/01/2007 - "Dopamine receptor (DR) expression and dopamine agonist (DA) effectiveness have never been demonstrated in neuroendocrine tumors associated with ectopic ACTH syndrome (EAS). "
02/01/2012 - "This case report demonstrates the management of ectopic ACTH-syndrome by molecularly -targeted therapy with dopamine receptor -agonists as well as improved detection of the ectopic ACTH source by novel imaging modalities, such as [(68)Ga-DOTA]-TATE PET specifically targeting somatostatin receptor subtype-2 with high affinity."

01/01/1997 - "To determine the efficacy of cortisol and its metabolite, cortisone, measured simultaneously by high performance liquid chromatography (HPLC) in the diagnosis of Cushing's syndrome, we retrospectively reviewed the histories of 29 surgically proven Cushing's syndrome patients (20 Cushing's disease, 5 ectopic ACTH syndrome, and 4 adrenal Cushing's syndrome) and 6 patients with exogenous Cushing's syndrome. "
12/01/1992 - "Plasma cortisol/cortisone ratios were higher in ectopic ACTH syndrome than in other forms of Cushing's syndrome. "
12/01/2003 - "Hypertension and severe hypokalemia were present and high urinary free cortisol/cortisone ratio was detected, raising a suspicion of an ectopic ACTH syndrome. "

02/01/2008 - "Laparoscopic bilateral adrenalectomy for ectopic ACTH syndrome refractory to medical management can be performed with low morbidity. "
02/01/2008 - "Two women with occult ectopic ACTH syndrome, refractory to medical management, underwent laparoscopic bilateral adrenalectomies. "
02/01/2008 - "Adrenalectomies performed by the authors were identified and the outcomes of laparoscopic bilateral adrenalectomies for ectopic ACTH syndrome were examined. "
02/01/2008 - "In this paper, we review our experience with laparoscopic bilateral adrenalectomy for occult ectopic ACTH syndrome. "
02/01/2008 - "Laparoscopic bilateral adrenalectomy for occult ectopic ACTH syndrome."

10/01/1997 - "After an intravenous injection of 5 microg DDAVP, plasma ACTH levels increased to more than 200% of the basal levels in 10 of 10 patients with Cushing's disease, but remained less than 150% in all of 11 normal subjects, 3 patients with Addison's disease, 5 cases of Cushing's disease in remission, and 3 patients with ectopic ACTH syndrome. "
09/01/1989 - "The combined intravenous injection of TRH and GnRH elicited paradoxical responses of plasma beta-endorphin in active and successfully treated pituitary dependent Cushing's disease as well as in ectopic ACTH syndrome and in congenital adrenal hyperplasia. "

07/01/2009 - "Combination chemotherapy may prove effective in the treatment of small-cell lung cancer with ectopic ACTH syndrome, hypothyroidism and hypogonadism."
12/01/2003 - "Ectopic ACTH syndrome due to thymic atypical carcinoid treated with combination chemotherapy of cisplatin and etoposide."

10/01/1994 - "In three tumors responsible for the ectopic ACTH syndrome, CLIP peptides were predominant in two and phosphorylated molecules represented between 22% and 50% of immunoreactive materials. "
01/01/1988 - "It is often altered in non-pituitary tumors responsible for the ectopic ACTH syndrome: abnormal peptides may be generated (CLIP h beta MSH5-22) which can be detected in blood. "
11/01/1980 - "Adrenocorticotrophin, lipotrophin and the related peptides alpha-MSH, CLIP, beta-endorphin and met-enkephalin have been measured, and characterized chromatographically in tumour extracts from seven patients with the ectopic ACTH syndrome. "
12/01/1989 - "In order to evaluate which of human (h) corticotrophin-like intermediary lobe peptide (CLIP) or h beta-melanocyte stimulating hormone5-22 (h beta MSH5-22) was the better marker of alternate pro-opiomelanocortin (POMC) processing, both peptides were simultaneously sought in the same tissue extracts from a normal human pituitary, six corticotrophic adenomas, and four non-pituitary tumours responsible for an ectopic ACTH syndrome. "
01/01/1981 - "ACTH, beta-LPH, gamma-LPH and beta-endorphin are observed in the plasma of normal subjects and patients with increased pituitary ACTH secretion, whereas cerebrospinal fluid contains ACTH, beta-LPH, gamma-LPH and beta-endorphin, a 31 000-molecular-weight putative precursor having ACTH, LPH and gamma-MSH immunoreactivities, as well as pro-gamma-MSH(1-77) and smaller immunoreactive gamma-MSH fragments, alpha-MSH was not observed in blood or cerebrospinal fluid but this pars intermedia peptide and corticotropin-like intermediate lobe peptide (CLIP) were both found in tumour tissues obtained from patients with the ectopic ACTH syndrome. "

05/01/2007 - "Main indications for drug therapy include preparation for surgery, persistence or recurrence after surgery, while awaiting for the effect of radiation therapy, occult ectopic ACTH syndrome, severe hypercortisolism and malignancy related hypercortisolism."
09/01/1981 - "Further analysis of these cases suggests that the development of the ectopic ACTH syndrome may reflect changes in cell populations within the tumor and/or alterations in tumor behavior with time and perhaps with the effects of drug therapy."
04/01/1999 - "Marked increase in plasma ACTH with tumor reduction after chemotherapy in ectopic ACTH syndrome."
04/01/1999 - "We report on a case of rapid and marked hormone release as a result of rapid tumor reduction due to chemotherapy in a 36-year-old woman with ectopic ACTH syndrome due to small cell lung cancer. "
04/01/1999 - "The present case indicates that anticancer chemotherapy instituted in patients with ectopic ACTH syndrome could result in an acute increase of plasma ACTH and exacerbation of hypercortisolism, similar to tumor lysis syndrome, which is a potentially fatal complication following anti-cancer chemotherapy."