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Ectopic Cushing's syndrome due to concurrent corticotropin-releasing hormone (CRH) and adrenocorticotropic hormone (ACTH) secreted by malignant gastrinoma

Authors
 S. Y. Park  ;  Y. Rhee  ;  S. -K. Lim  ;  S. Y. Song  ;  D. M. Kim  ;  S. Lee  ;  Y. N. Park  ;  J. C. Youn 
Citation
 Experimental and Clinical Endocrinology & Diabetes, Vol.115(1) : 13-16, 2007 
Journal Title
 Experimental and Clinical Endocrinology & Diabetes 
ISSN
 0947-7349 
Issue Date
2007
Abstract
Ectopic Cushing's syndrome due to various malignancies is not uncommon. However, a few cases of ectopic Cushing's syndrome caused by corticotropin-releasing hormone (CRH), or CRH with adrenocorticotropic hormone (ACTH) have been reported. A 28-year-old woman presented with acute upper gastrointestinal bleeding caused by an active ulcer, located atypically in the 2nd portion of duodenum. Further work-up revealed high gastrin levels and abdominal computed tomography (CT) scans showed a large pancreatic head mass with multiple liver metastases. The serum cortisol and ACTH levels were checked due to hypokalemia with metabolic alkalosis and recent amenorrhea. Cortisol and ACTH were both highly elevated with pituitary hyperplasia and elevated CRH. The existence of ectopic ACTH and CRH in the liver biopsy was also demonstrated immunohistochemically. Since an operation was not feasible, chemotherapy was conducted using paclitaxel and etoposide. These two drugs were chosen according to the in vitro chemotherapy response assay to maximize the treatment. This report demonstrates concurrent ACTH- and CRH-related ectopic Cushing's syndrome caused by malignant gastrinoma with multiple liver metastases that was treated with marginal success using a multidisciplinary medical approach.
Full Text
https://www.thieme-connect.com/DOI/DOI?10.1055/s-2007-948212
DOI
10.1055/s-2007-948212
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dol Mi(김똘미)
Park, So Young(박소영)
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
Youn, Jong Chan(윤종찬)
Lee, Si Hoon(이시훈)
Rhee, Yumie(이유미) ORCID logo https://orcid.org/0000-0003-4227-5638
Lim, Sung Kil(임승길)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/96021
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