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ectopic ACTH

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https://www.readbyqxmd.com/read/29440131/diagnostic-accuracy-and-comparison-of-bipss-in-response-to-lysine-vasopressin-and-hcrh
#1
Kush Dev Singh Jarial, Anil Bhansali, Vivek Gupta, Paramjeet Singh, Kanchan K Mukherjee, Akhilesh Sharma, Rakesh Vasishta, Suja P Sukumar, Naresh Sachdeva, Rama Walia
CONTEXT: Bilateral inferior petrosal sinus sampling (BIPSS) using hCRH is currently considered the 'gold standard' test for the differential diagnosis of ACTH-dependent Cushing's syndrome (CS). Vasopressin is more potent than CRH to stimulate ACTH secretion as shown in animal studies, however; no comparative data of its use is available during BIPSS. OBJECTIVE: To study the diagnostic accuracy and comparison of hCRH and lysine vasopressin (LVP) stimulation during BIPSS...
February 12, 2018: Endocrine Connections
https://www.readbyqxmd.com/read/29387897/-endocrine-paraneoplastic-syndromes
#2
REVIEW
N Reisch, M Reincke
Endocrine paraneoplastic syndromes result from the production of bioactive substances from neoplastic cells, of endocrine or neuroendocrine origin. Typically these are located in the lungs, the gastrointestinal tract, pancreas, thyroid gland, adrenal medulla, skin, prostate or breast. In endocrine paraneoplastic syndromes the secretion of peptides, amines or other bioactive substances is always ectopic and not related to the anatomical source. The clinical presentation, however, is indistinguishable from a suspected eutopic endocrine tumor posing a diagnostic challenge...
January 31, 2018: Der Internist
https://www.readbyqxmd.com/read/29340776/ectopic-cushing-s-syndrome-secondary-to-olfactory-neuroblastoma
#3
Kenny Yu, Federico Roncaroli, Tara Kearney, David Ewins, Deepa Beeharry, Thomas Naylor, David Ray, Rajiv Bhalla, Kanna Gnanalingham
We present the case of a patient with Cushing's syndrome secondary to ectopic ACTH secretion. A MR of the head showed a left-sided nasal mass extending down from the cribriform plate. The patient underwent endoscopic resection with nearly complete removal of the mass. Histological examination showed an ACTH-secreting olfactory neuroblastoma (ONB). The patient's cortisol levels returned to normal range after surgery and have remained normal for over a year. ONB is a rare cause for ectopic ACTH secretion. This case highlights the diagnostic and management difficulties in patients with ectopic ACTH secretion, and provides a brief review of ONB...
January 17, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29217652/initial-clinical-presentation-and-spectrum-of-pheochromocytoma-a-study-of-94-cases-from-a-single-center
#4
Henrik Falhammar, Magnus Kjellman, Jan Calissendorff
BACKGROUND: With the increasing access to imaging more pheochromocytomas are diagnosed in the workup of adrenal incidentalomas. This may have changed the occurrence of the classic presentation with hypertension and the classic triad (headaches, sweating and palpitation). METHODS: We reviewed 94 consecutive cases of pheochromocytomas. Two cases of ectopic ACTH-syndrome were subsequently excluded. RESULTS: Of the 92 cases included 64% had presented as an incidentaloma, 32% as a suspected pheochromocytoma and 4% had been screened because of previously diagnosed MEN2A...
December 7, 2017: Endocrine Connections
https://www.readbyqxmd.com/read/29202350/case-report-ectopic-cushing-s-syndrome-in-a-young-male-with-hidden-lung-carcinoid-tumor
#5
Ghanem Aljassem, Hazem Aljasem
INTRODUCTION: Ectopic Cushing syndrome is a form of Cushing's in which a tumor outside the pituitary gland produces adrenocorticotropic hormone (ACTH). Small cell carcinoma and carcinoid of the lung comprises half of its cases. The main purpose of this study is to present a case of ectopic Cushing syndrome caused by a hidden lung carcinoid and how to manage it. PRESENTATION OF CASE: Here we present a case of a 26year old young male complains of increased weight and appetite, proximal muscle weakness, easy bruising and appearing of purple striae on his abdomen, with a final diagnosis of ACTH secreting lung carcinoid...
November 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29189371/ectopic-adrenocorticotropic-hormone-secreting-pituitary-adenoma-localized-by-18f-choline-pet-ct
#6
Alessandro Sindoni, Valentina Bodanza, Rosa Tatta, Tanja Baresic, Eugenio Borsatti
The criterion standard of treatment of an adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma is complete surgical excision. However, ectopic location of these adenomas is an extremely rare condition, which may affect the diagnosis and treatment success. We report a case of a 49-year-old man who was referred to our institution with persistent hypercortisolemia after an unsuccessful attempt of surgical resection. F-choline PET/CT revealed increased radiopharmaceutical uptake in a nodule localized in the left maxillary sinus, which was proved at histology to be an ectopic ACTH-secreting pituitary adenoma staining positive for ACTH...
November 17, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29164929/psychosis-as-a-sequelae-of-paraneoplastic-syndrome-in-small-cell-lung-carcinoma-a-psycho-neuroendocrine-interface
#7
Christiana M Wilkins, Victoria L Johnson, Rachel E Fargason, Badari Birur
In 2013 more than 150,000 Americans died from all types of lung cancer. Small cell lung cancer (SCLC) represents about 13% of all lung cancers and is notoriously associated with paraneoplastic syndromes (PNS). Here we present an interesting case of psychosis associated with one such PNS-- ectopic Cushing syndrome of SCLC. A 56 year old African-American male with no prior psychiatric history who was diagnosed with SCLC two months prior, presented to the ER for treatment of a right arm laceration he sustained while fighting off attackers, with high concern these individuals may have been part of hallucinatory experiences and well-systematized persecutory delusions regarding his wife...
November 22, 2017: Clinical Schizophrenia & related Psychoses
https://www.readbyqxmd.com/read/29161416/combined-ovarian-and-adrenal-venous-sampling-in-the-localization-of-acth-independent-ectopic-cushing-s-syndrome
#8
Shi Chen, Ran Li, Xiaobo Zhang, Lin Lu, Ji Li, Hui Pan, Huijuan Zhu
Context: Cushing's syndrome is rarely caused by the secretion of cortisol from the ovarian tumors. It is important to determine whether the ovarian tumor is capable of secreting cortisol or not in clinical decision making. Selective ovarian and adrenal venous sampling has not been reported previously in the localization of ACTH-independent ectopic Cushing's syndrome. Case description: Herein, we presented a case of 40-year-old Chinese woman who has been manifested with weight gain, hirsutism, hypertension and menstrual disorder over a period of 6 months...
November 16, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29158903/severe-cushing-s-syndrome-and-bilateral-pulmonary-nodules-beyond-ectopic-acth
#9
Carlos Tavares Bello, Emma van der Poest Clement, Richard Feelders
Cushing's syndrome is a rare disease that results from prolonged exposure to supraphysiological levels of glucocorticoids. Severe and rapidly progressive cases are often, but not exclusively, attributable to ectopic ACTH secretion. Extreme hypercortisolism usually has florid metabolic consequences and is associated with an increased infectious and thrombotic risk. The authors report on a case of a 51-year-old male that presented with severe Cushing's syndrome secondary to an ACTH-secreting pituitary macroadenoma, whose diagnostic workup was affected by concurrent subclinical multifocal pulmonary infectious nodules...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29152267/acromegaly-and-cushing-s-syndrome-caused-by-a-neuroendocrine-tumor-arising-within-a-sacrococcygeal-teratoma
#10
Tarig Babiker, Efstathia Kyrodimou, Daniel M Berney, Mark Gurnell, William M Drake, Antonia Brooke
A 60-year-old man with a pre-existing stable sacrococcygeal teratoma developed acromegaly, ectopic Cushing's syndrome, and 5HIAA secretion. To our knowledge, this represents the first reported case of ACTH and serotonin secretion, and likely GHRH or GH cosecretion, from a sacrococcygeal teratoma in an adult.
November 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/29141926/ectopic-acth-syndrome-complicated-by-multiple-opportunistic-infections-treated-with-percutaneous-ablation-of-the-adrenal-glands
#11
Chrystal Chan, James Mark Roberts
Ectopic adrenocorticotropic hormone (ACTH)-related Cushing's syndrome can lead to multiple complications including severe immunosuppression. If the ACTH-secreting tumour cannot be found, definitive treatment is surgical adrenalectomy, typically followed by glucocorticoid replacement. Here, we present a case of fulminant respiratory failure secondary to coinfection with Pneumocystis jirovecii and cytomegalovirus in a patient with ectopic ACTH-dependent Cushing's syndrome with occult primary. Due to significant deconditioning, she was unable to undergo definitive adrenalectomy and instead underwent percutaneous microwave ablation of the adrenal glands...
November 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29107171/progression-from-isolated-growth-hormone-deficiency-to-combined-pituitary-hormone-deficiency
#12
REVIEW
Manuela Cerbone, Mehul T Dattani
Growth hormone deficiency (GHD) can present at any time of life from the neonatal period to adulthood, as a result of congenital or acquired insults. It can present as an isolated problem (IGHD) or in combination with other pituitary hormone deficiencies (CPHD). Pituitary deficits can evolve at any time from GHD diagnosis. The number, severity and timing of occurrence of additional endocrinopathies are highly variable. The risk of progression from IGHD to CPHD in children varies depending on the etiology (idiopathic vs organic)...
December 2017: Growth Hormone & IGF Research
https://www.readbyqxmd.com/read/29104610/functional-pancreatic-neuroendocrine-tumour-causing-cushing-s-syndrome-the-effect-of-chemotherapy-on-clinical-symptoms
#13
Paulo Henrique do Amor Divino, Katia Regina Marchetti, Madson Q Almeida, Rachel P Riechelmann
Background: Neuroendocrine tumours (NETs) are a heterogeneous group of diseases that can originate from any part of the gastrointestinal tract, bronchi, thyroid and pancreas. These tumours may be functioning or not depending on their ability to produce active substances, such as adrenocorticotrophic hormone (ACTH). ACTH-producing pancreatic neuroendocrine tumours are rare, with limited data about effective antitumor therapies. Case Report: A 58-year-old man with a history of type-2 diabetes mellitus and arterial hypertension was diagnosed with Cushing's syndrome (CS) secondary to an ACTH ectopic production from a well-differentiated neuroendocrine tumour of the pancreas metastatic to the liver...
2017: Ecancermedicalscience
https://www.readbyqxmd.com/read/29080355/tumour-lateralization-in-cushing-s-disease-by-inferior-petrosal-sinus-sampling-with-desmopressin
#14
Ming Feng, Ziyuan Liu, Xiaohai Liu, Xiaobo Zhang, Xinjie Bao, Yong Yao, Kan Deng, Bing Xing, Wei Lian, Huijuan Zhu, Lin Lu, Renzhi Wang
BACKGROUND: Bilateral inferior petrosal sinus sampling (IPSS) with corticotropin-releasing hormone (CRH) is currently the gold standard in the diagnosis of Cushing's disease (CD) and has also been used in tumour lateralization. Our objective was to determine the diagnostic value and lateralization accuracy of IPSS with desmopressin. METHODS: We retrospectively analyzed 91 patients with Cushing's syndrome who had either negative findings on pituitary dynamic enhanced magnetic resonance imaging (MRI) or non-suppressed high dose dexamethasone suppression tests (HDDST)...
October 28, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/29063495/calcitonin-producing-neuroendocrine-neoplasms-of-the-pancreas-clinicopathological-study-of-25-cases-and-review-of-the-literature
#15
Silvia Uccella, Annika Blank, Roberta Maragliano, Fausto Sessa, Aurel Perren, Stefano La Rosa
Increased levels of circulating calcitonin are a clue in the diagnosis of medullary thyroid carcinoma. However, hypercalcitoninemia can also be related to other pathological conditions, including pancreatic neuroendocrine neoplasms (PanNENs). Ectopic hormonal production is not unusual in both functioning and non-functioning PanNENs; however, little is known about the frequency of calcitonin expression in these neoplasms. The aims of this study were to assess the frequency of calcitonin immunoreactivity in PanNENs, independently from serum calcitonin levels, and to evaluate the clinicopathological and prognostic features of calcitonin-immunoreactive (Cal-IR) PanNENs, including a comparison with cases already reported in the literature...
December 2017: Endocrine Pathology
https://www.readbyqxmd.com/read/28910955/-the-localization-diagnosis-of-patients-with-adrenocorticotropic-hormone-dependent-cushing-s-syndrome-in-adolescence
#16
S Chen, Z X Pan, L Lu, A L Tong, H Pan, H J Zhu, Y Yao, M Feng, R Z Wang, Z L Lu
Objective: To elucidate the clinical characteristics and localization diagnosis of patients with adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome (CS) in adolescence. Methods: The clinical data, laboratory examination and localization diagnosis from 35 patients aged less than 18 years old with adolescent CS who were treated at Peking Union Medical College Hospital between January 1990 and March 2012 were analyzed. Results: There were 29 cases of Cushing's disease (CD) and 6 cases of ectopic ACTH syndrome (EAS)...
September 12, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28895465/paraneoplastic-cushing-syndrome-case-series-and-review-of-the-literature
#17
Annelies Deldycke, Christel Haenebalcke, Youri Taes
OBJECTIVES: Paraneoplastic Cushing syndrome is a rare condition, representing a small fraction of the adrenocorticotropic hormone (ACTH)-dependent cases of Cushing syndrome Methods: Four case descriptions and literature review, highlighting the diagnostic challenges and treatment options are presented. RESULTS: Different tumor types can be associated with ectopic ACTH secretion. The most common types are bronchial carcinoids and small cell lung carcinoma (SCLC)...
September 12, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28862247/ectopic-adrenocorticotropic-hormone-syndrome-in-a-case-of-duodenal-neuroendocrine-tumor-presenting-with-liver-metastasis
#18
J Khare, S Daga, S Nalla, P Deb
Ectopic adrenocorticotropic hormone (ACTH) syndrome is an uncommon disorder and comprises about 15% of all patients with Cushing's syndrome (CS). Duodenal carcinoids are rare, indolent tumors usually associated with a benign progression. We hereby report a rare case of CS resulting from ectopic ACTH secretion from a duodenal neuroendocrine tumor (NET) presenting with liver metastasis. A 37-year-old female presented with abdominal discomfort and dyspepsia of 1-month duration. Ultrasound abdomen suggested a well-defined hypoechoic lesion in the left lobe of the liver, suggestive of neoplasia...
August 31, 2017: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/28834902/cushing-s-syndrome-secondary-to-typical-pulmonary-carcinoid-with-mutation-in-bcor-gene-a-case-report
#19
Yimin Wu, Lan Yue, Jinfan Li, Mingjing Yuan, Ying Chai
RATIONALE: Typical pulmonary carcinoid is a kind of low-grade malignancy neuroendocrine tumor. Cushing's syndrome is a very rare clinical feature of typical pulmonary carcinoid caused by hypercorticism. Complete tumor resection is the standard curative treatment for primary typical pulmonary carcinoid. However, our knowledge on the gene level of typical pulmonary carcinoid is limited. PATIENT CONCERNS: A 42-year-old man was admitted to our hospital for progressive weight gain within one year...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28816283/-surgery-treatment-of-ectopic-adrenocorticotrophic-hormone-syndrome
#20
H Fan, H Z Li, W F Xu, Z G Ji, Y S Zhang
OBJECTIVE: To investigation the diagnosis and treatment of ectopic adrenocorticotrophic hormone (ACTH) syndrome. METHODS: The clinical characters of 57 cases of ecotopic ACTH syndrome from Jan. 1996 to Dec. 2016 were collected and analyzed. The 57 cases included 32 males and 25 females. The age ranged from 11 to 68 years (average 32 years). ACTH levels significantly increased from 16.5 to 365.6 pmol/L, with average 77.6 pmol/L (normal range <10.1 pmol/L). The pituitary MRI did not found lesions...
August 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
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