Cushing's Syndrome Following Ectopic Neoplastic Production of Corticotropin

Abstract

In recent years it has been frequently reported that not only pathological alterations of the pituitary, hypothalamic centers or the adrenal glands, but also non-endocrine corticotropin producing syndromes lead to Cushing's syndrome. The demonstration of an ectopic ACTH syndrome, however, depends on the determination of ACTH in the tumor tissue. We succeeded in extracting a corticotropic substance from malignant tumors or their metastases. Since bio- and immunoassay of the same tumor extract yielded different results, an atypical ACTH molecule produced by the tumor was assumed. This was further supported by the abnormally high stimulation of corticosterone in our patients and the pathologically increased content of MSH. In order to exclude non-specific corticotropic activity, the ACTH content of tumors, metastases and urine were compared with the negative results of normal liver tissue and normal urine.

Key words

Ectopic ACTH Syndrome - ACTH-Extraction - Biological Assay of ACTH - Radioimmunoassay of ACTH

1 Part of this paper was presented as a dissertation for promotion to Doctor of Medicine at the Clinical Faculty of the University of Ulm.