1. Adrenocorticotropic hormone-producing pheochromocytoma: analysis of clinical cases
- Author
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Evgeniya Ivanovna Marova, Iya Aleksandrovna Voronkova, Anastasiya Mikhaylovna Lapshina, Svetlana Dmitrievna Arapova, Nikolay Sergeevich Kuznetsov, Lyudmila Yakovlevna Rozhinskaya, Vladimir Anatol'evich Zhivotov, Oleg Borisovich Zharkov, Larisa Evseevna Gurevich, and Galina Aleksandrovna Polyakova
- Subjects
ectopic cushing’s syndrome ,pheochromocytoma ,Physiology ,QP1-981 ,Biochemistry ,QD415-436 - Abstract
Ectopic secretion of ACTH from non-pituitary tumors, referred to as ectopic ACTH syndrome (EAS), accounts for about 10–20% of Cushing’s syndrome (CS). Ectopic hormone-secreting pheochromocytomas (Pheo) are rare. The first publication of association between pheochromocytoma and Cushing’s syndrome by Roux is dated 1955. Pheochromocytoma represents a rare cause of hypercortisolism, accounting for less than 5 % of ectopic Cushing’s syndrome while less than 1 % of pheochromocytomas is accompanied by Cushing’s syndrome.We are reporting 4 cases of ACTH-secreting pheochromocytoma presenting as Cushing’s syndrome. Data from 4 patients were analysed. There were 4 women from 50 to 63 years old. All patients had a clinical presentation of hypercorticoidism. Their levels of adrenocorticotropic hormone in plasma, 24-hour urinary free cortisol and urinary catecholamine were high. Computed tomography scan of the abdomen in all cases revealed a mass in the left adrenal gland. Left sided adrenalectomy was performed under treatment with a-blocker doxazosin and b-blocker atenolol. Histological examination revealed in 3 cases – pheocromocytoma and in 1 case corticomedullary mixed tumor of the adrenal gland. Additional immunostaining (IHC)of these tumors showed positive immunostaining for chromogranin and ACTH. The IHC search for somatostatin receptors of subtype 2 and 5 (SSTR2, SSTR5) was performed in 3 cases and showed predominately expression SSTR2. The case index of Ki-67 ranged, from 0,5 to 4%. Biochemical signs of hypercortisolism rapidly began to disappear after surgery. Follow up of the patients during the next 2 years on average was with disease remission.
- Published
- 2015
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