Metastatic pancreatic neuroendocrine carcinoma causing Cushing's syndrome. ACTH secretion by metastases 3 years after resection of nonfunctioning primary cancer.

Abstract

CONCLUSION:

Following resection of a nonfunctioning neuroendocrine carcinoma of the pancreas, subsequent metastases, in the absence of a primary cancer (resected), developed the capacity to secrete ACTH and create the Cushing syndrome.

BACKGROUND:

Although neuroendocrine carcinomas of the pancreas may produce one or more hormones and may switch secretion to a different hormone, no report is identified of a metastasis, in the absence of the primary tumor, developing de novo the capacity to secrete ACTH.

METHODS:

A nonfunctioning islet cell carcinoma was resected and immunochemically stained for multiple hormones. Three years later hepatic metastases were partially resected and stained as before.

RESULTS:

The primary cancer stained negative for ACTH and cortisol, positive for serotonin, and focally positive for gastrin. Three years later, after the development of a florid Cushing syndrome, the metastasis stained strongly for ACTH and negative for serotonin.

• Authors: L Zhu, D R Domenico, J M Howard
• Journal: International journal of pancreatology : official journal of the International Association of Pancreatology (Int J Pancreatol) Vol. 19 Issue 3 Pg. 205-8 (Jun 1996) ISSN: 0169-4197 [Print] United States
• PMID: 8807366 (Publication Type: Case Reports, Journal Article)

Chemical References

• Serotonin
• Adrenocorticotropic Hormone

Topics

• Adrenocorticotropic Hormone (metabolism)
• Carcinoma, Neuroendocrine (complications, metabolism, secondary)
• Cushing Syndrome (etiology)
• Humans
• Immunohistochemistry (methods)
• Male
• Middle Aged
• Pancreatic Neoplasms (complications, metabolism, secondary)
• Serotonin (metabolism)
• Staining and Labeling