From 1984 to 1990, six patients with histologically and endocrinologically proven
ectopic ACTH syndrome were treated in our department. The lesion in five patients was clinically evident, but in the other was occult. All lesions were located within the chest. Four were thymic
carcinoid and the other two were bronchial
carcinoids. Most of the patients had typical clinical manifestations of
Cushing's syndrome. Laboratory tests including histopathological examination confirmed the diagnosis of
ectopic ACTH syndrome. The treatment consisted of surgical removal of the mass supplemented by
radiotherapy. The results showed that
after treatment all patients had satisfactory remission. Two bronchial
carcinoid patients have been living for 40 and 88 months respectively without recurrence. Among 4 thymic
carcinoid patients, only one has been living with no
tumor for 34 months. One patient had recurrence and the other 2 died 32 and 50 months after the treatment respectively. However, the symptoms of two thymic
carcinoid patients had not been relieved at all until
radiotherapy was given. This paper discusses the method, dose and indications of
radiotherapy. It should be pointed out that the prognosis of bronchial
carcinoids is good while that of thymic
carcinoids is relatively poor.