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Acromegaly and Cushing's syndrome associated with a foregut carcinoid tumor.

Publication ,  Journal Article
Leveston, SA; McKeel, DW; Buckley, PJ; Deschryver, K; Greider, MH; Jaffe, BM; Daughaday, WH
Published in: J Clin Endocrinol Metab
October 1981

We report an 18-yr-old youth with a metastatic foregut carcinoid tumor, Cushing's syndrome, and hypersomatotropic gigantism. Administration of cyproheptadine caused a dramatic fall in urinary cortisol excretion and plasma ACTH levels associated with clinical remission of the Cushing's syndrome. GH secretion was not affected by cyproheptadine administration. Ectopic ACTH secretion was confirmed by RIA of tumor extracts and immunohistochemical demonstration of ACTH-containing cells in hepatic metastases. There were two sources of GH production demonstrated in this patient. Ectopic secretion of GH by the carcinoid hepatic metastases was documented by both RIA and immunohistochemical techniques. A somatotrophic pituitary tumor was also present. The histological characteristics of this tumor suggest adenomatous hyperplasia rather than de novo neoplastic change as the likely mechanism of its pathogenesis. GH releasing factor-like activity was demonstrated in extracts of plasma and in extracts of the carcinoid tumor. We conclude that cyproheptadine exerted an effect on the ectopic ACTH-producing cells but not on the ectopic GH-producing cells or on adenohypophyseal GH secretion. Production of a GH releasing factor-like activity by the carcinoid tumor may have caused the pituitary somatotrophic tumor.

Duke Scholars

Published In

J Clin Endocrinol Metab

DOI

ISSN

0021-972X

Publication Date

October 1981

Volume

53

Issue

4

Start / End Page

682 / 689

Location

United States

Related Subject Headings

  • Thyroid Hormones
  • Pituitary Neoplasms
  • Pituitary Gland
  • Male
  • Hydrocortisone
  • Humans
  • Growth Hormone-Releasing Hormone
  • Growth Hormone
  • Endocrinology & Metabolism
  • Cyproheptadine
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Leveston, S. A., McKeel, D. W., Buckley, P. J., Deschryver, K., Greider, M. H., Jaffe, B. M., & Daughaday, W. H. (1981). Acromegaly and Cushing's syndrome associated with a foregut carcinoid tumor. J Clin Endocrinol Metab, 53(4), 682–689. https://doi.org/10.1210/jcem-53-4-682
Leveston, S. A., D. W. McKeel, P. J. Buckley, K. Deschryver, M. H. Greider, B. M. Jaffe, and W. H. Daughaday. “Acromegaly and Cushing's syndrome associated with a foregut carcinoid tumor.J Clin Endocrinol Metab 53, no. 4 (October 1981): 682–89. https://doi.org/10.1210/jcem-53-4-682.
Leveston SA, McKeel DW, Buckley PJ, Deschryver K, Greider MH, Jaffe BM, et al. Acromegaly and Cushing's syndrome associated with a foregut carcinoid tumor. J Clin Endocrinol Metab. 1981 Oct;53(4):682–9.
Leveston, S. A., et al. “Acromegaly and Cushing's syndrome associated with a foregut carcinoid tumor.J Clin Endocrinol Metab, vol. 53, no. 4, Oct. 1981, pp. 682–89. Pubmed, doi:10.1210/jcem-53-4-682.
Leveston SA, McKeel DW, Buckley PJ, Deschryver K, Greider MH, Jaffe BM, Daughaday WH. Acromegaly and Cushing's syndrome associated with a foregut carcinoid tumor. J Clin Endocrinol Metab. 1981 Oct;53(4):682–689.
Journal cover image

Published In

J Clin Endocrinol Metab

DOI

ISSN

0021-972X

Publication Date

October 1981

Volume

53

Issue

4

Start / End Page

682 / 689

Location

United States

Related Subject Headings

  • Thyroid Hormones
  • Pituitary Neoplasms
  • Pituitary Gland
  • Male
  • Hydrocortisone
  • Humans
  • Growth Hormone-Releasing Hormone
  • Growth Hormone
  • Endocrinology & Metabolism
  • Cyproheptadine