Adrenal-pituitary Studies in a Patient with Bronchogenic Carcinoma and Cushing's Syndrome
Authors: RICHARD A. PFOHL
Journal: Annals of Internal Medicine (1963)

Case Studies1 June 1963Adrenal-pituitary Studies in a Patient with Bronchogenic Carcinoma and Cushing's SyndromeRICHARD A. PFOHL, M.D., RICHARD P. DOE, M.D.RICHARD A. PFOHL, M.D.Search for more papers by this author, RICHARD P. DOE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-58-6-993 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAn increasing association has been noted between anaplastic carcinoma of the lung and Cushing's syndrome. Elevated plasma and urinary 17-hydroxycorticosteroid (17-OHCS) concentrations are frequently associated with a hypokalemic alkalosis and less commonly with the more classical features of Cushing's syndrome. The present case report represents the fourth such patient seen at our hospital (1, 2) and at least the forty-sixth patient with this association reported in the literature (2-7) Most previous reports have had an incomplete adrenal-pituitary evaluation probably due in part to the usually rapid fatal course. The adrenal studies obtained on this patient may help to further elucidate...References1. METZLERFLINK CEB: Adrenal cortical hyperfunction associated with metastatic bronchogenic carcinoma. J. Lancet 76: 242, 1956. MedlineGoogle Scholar2. HYMESDOE AR: Adrenal function in cancer of the lung with and without Cushing's syndrome. Amer. J. Med. 33: 398, 1962. CrossrefMedlineGoogle Scholar3. HUDSONEVANS BJ: Adrenocortical hyperplasia associated with bronchogenic carcinoma. J. Clin. Endocr. 22: 494, 1962. CrossrefGoogle Scholar4. MEADORLIDDLEISLANDNICHOLSONLUCASNUCKTONLUETSCHER CKGWDPWECPJGJA: Cause of Cushing's syndrome in patients with tumors arising from "non-neuroendocrine" tissue. Ibid., 693. Google Scholar5. MARKSROSENBAUMRUSSFIELD LJDLAB: Cushing's syndrome and corticotropin-secreting carcinoma of the lung. Ann. Intern. Med. 58: 143, 1963. LinkGoogle Scholar6. THOMPSONHORWICKDAVIS GSLLC: Carcinoma of bronchus and Cushing's syndrome. Lancet 1: 534, 1963. Google Scholar7. SCHOLZRIGGSBAHNLIDDLE DABLRCGW: Adrenocortical hyperfunction associated with a corticotrophin-secreting bronchogenic carcinoma: report of case. Proc. Mayo Clin. 38: 45, 1963. MedlineGoogle Scholar8. PETERSONKARBERGUERRA REASL: Evaluation of the Silber-Porter procedure for the determination of plasma hydrocortisone. Anal. Chem. 29: 144, 1957. CrossrefGoogle Scholar9. DOESEALFERNANDEZ RPUSRF: The measurement of non-protein bound plasma cortisol. Presented at the Forty-third Annual Meeting of the Endocrine Society, June, 1961, New York. (abstract 103). Google Scholar10. DOEVENNESFLINK RPJAEB: Diurnal variation of 17-hydroxycorticosteroids, sodium, potassium, magnesium, and creatinine in normals, treated adrenal insufficiency and Cushing's syndrome. J. Clin. Endocr. 20: 253, 1960. CrossrefGoogle Scholar11. HENKEDOEJACOBSON WJRPME: A test of pituitary reserve utilizing intravenous SU4885, with a new method for extraction of 11-dosoxycorticosteroids. Ibid., 1527. Google Scholar12. LIDDLE GW: Tests of pituitary-adrenal suppressibility in the diagnosis of Cushing's syndrome. Ibid., 1539. Google Scholar13. DEMOORHEIRWEGHHERMANSDECLERCK-RASKIN PKJFM: Protein binding of corticoids studied by gel filtration. J. Clin. Invest. 41: 816, 1962. CrossrefMedlineGoogle Scholar14. DREKTERHEISLERSCISMSTERNPEARSONMCGAVACK JJAGRSSTH: The determination of urinary steroids. I. The preparation of pigment-free extracts and a simplified procedure for the estimation of total 17-ketosteroids. J. Clin. Endocr. 12: 55, 1952. CrossrefMedlineGoogle Scholar15. LIDDLEISLANDNEYNICHOLSONSHIMIZA GWDPRLWEN: Ectopic "ACTH" produced by non-pituitary neoplasms as a cause of Cushing's syndrome. Arch. Intern. Med. 111: 129, 1963. CrossrefGoogle Scholar16. NEYSHIMIZANICHOLSONISLANDLIDDLE RNWDG: Correlation of plasma ACTH concentration with adreno-cortical response in man. Presented at the Forty-fourth Annual Meeting of the Endocrine Society, June, 22, 1962, Chicago, Illinois. (abstract). Google Scholar17. CHRISTY NP: Adrenocorticotrophic activity in the plasma of patients with Cushing's syndrome associated with pulmonary neoplasms. Lancet 1: 85, 1961. CrossrefMedlineGoogle Scholar18. HOLUBKATZ DAFH: A possible etiological link between Cushing's syndrome and visceral malignancy. Clin. Res. 9: 194, 1961. Google Scholar19. BORNSTEINNOLANBERNANKE PJPD: Adrenocortical hyperfunction in association with anaplastic carcinoma of the respiratory tract. New Eng. J. Med. 264: 363, 1961. CrossrefGoogle Scholar20. JACOBSONFERNANDEZDOE MERRP: Methopyrapone (Metopirone) infusion studies in Cushing's syndrome. To be presented at the Forty-fifth Annual Meeting of the Endocrine Society, Atlantic City, June 14, 1963. (abstract). Google Scholar21. DOEFERNANDEZ RR: Unpublished data. Google Scholar22. WERKSHOLITONMACGEEMARNELL EWLJJRT: Increased excretion of 6β-hydroxy-cortisol (6β-OH-F) in patients with advanced cancer. Presented at the Forty-fourth Annual Meeting of the Endocrine Society, June, 1962, Chicago, Illinois. (abstract). Google Scholar23. WERKSHOLITON EWLJ: Adrenocortical function in carcinoma of the lung. Cancer 13: 469, 1960. CrossrefMedlineGoogle Scholar24. BELSKYMARKS JLLJ: Plasma 17-hydroxycorticosteroid responsiveness to ACTH in patients with bronchogenic carcinoma. Metabolism 11: 435, 1962. MedlineGoogle Scholar25. ROSENTHAL FO: Adrenocortical hyperactivity in a patient with bronchial carcinoma and diabetes mellitus. Brit. Med. J. 2: 139, 1957. CrossrefMedlineGoogle Scholar26. BLISSSANDBERGNELSONEIK-NES ELAADHK: The normal levels of 17-hydroxycorticosteroids in the peripheral blood of man. J. Clin. Invest. 32: 818, 1953. CrossrefMedlineGoogle Scholar27. DOEFLINKGOODSELL RPEBMG: Relationship of diurnal variation in 17-hydroxycorticosteroid levels in blood and urine to eosinophils and electrolyte excretion. J. Clin. Endocr. 16: 196, 1956. CrossrefGoogle Scholar28. EKMANHAKANSSONMCCARTHYLEHMANNSJOGREN HBJDJB: Plasma 17-hydroxycorticosteroid in Cushing's syndrome. J. Clin. Endocr. 21: 684, 1961. CrossrefMedlineGoogle Scholar29. NUGENTEIK-NESKENTSAMUELSTYLER CAKHSLTFH: A possible explanation for Cushing's syndrome associated with adrenal hyperplasia. J. Clin. Endocr. 20: 1259, 1960. CrossrefGoogle Scholar30. ENGLERTBROWNWOLLACHSIMONS EHSEL: Metabolism of free and conjugated 17-OH-CS in subjects with liver disease. J. Clin. Endocr. 17: 1395, 1957. CrossrefGoogle Scholar31. ALLOTTSKELTON EMMO: Increased adrenalcortical activity associated with malignant diseases. Lancet 2: 278, 1960. CrossrefMedlineGoogle Scholar32. DOEZINNEMANFLINKULSTROM RPHHEBRA: Significance of the concentration of nonprotein-bound plasma cortisol in normal subjects, Cushing's syndrome, pregnancy, and during estrogen therapy. J. Clin. Endocr. 20: 1484, 1960. CrossrefGoogle Scholar33. SANDBERGSLAUNWHITE AAWR: Transcortin: a corticosteroid-binding protein of plasma. V. In vitro inhibition of cortisol metabolism. J. Clin. Invest. 42: 51, 1963. CrossrefMedlineGoogle Scholar34. SEALDOE USRP: Corticosteroid-binding globulin. I. Isolation from plasma of diethyl-stilbestrol-treated men. J. Biol. Chem. 237: 3136, 1962. CrossrefMedlineGoogle Scholar35. PETERSONNOKESCHENBLACK REGPSRL: Estrogens and adrenocortical function in man. J. Clin. Endocr., 20: 495, 1960. CrossrefGoogle Scholar36. MILLSSCHEDLCHENBARTTER IHHPPSFC: The effect of estrogen administration on the metabolism and protein binding of hydrocortisone. Ibid., 515. Google Scholar37. WOLFSPEARYESNERPATNO JPRME: Biological Activity of Steroids in Relation to Cancer, ed. by Pincus, G., Academic Press, New York, 1960, p. 413. CrossrefGoogle Scholar38. NABARRO JD: Discussion on Cushing's syndrome. Proc. Roy. Soc. Med. 50: 768, 1957. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Minneapolis, MinnesotaFrom the Medical Service, Minneapolis Veterans Administration Hospital and the Department of Medicine, University of Minnesota.This study was supported in part by United States Public Health Service grants CA 05371 and CA 05113.Requests for reprints should be addressed to Richard P. Doe, M.D., Metabolic Section, Veterans Administration Hospital, 54th Street and 48th Avenue South, Minneapolis 17, Minnesota. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByThe Ectopic ACTH SyndromeRecent Advances in Human Steroid MetabolismMedullary cancer of the thyroid gland associated with hypercorticismClinical and Laboratory Studies of Ectopic Humoral SyndromesPathology of ‘nonendocrine’ tumors associated with Cushing's syndromeSteroid laboratory tests in the diagnosis of Cushing's syndromeCushing's syndrome caused by bronchial adenomasEndocrine Syndromes of Non-Endocrine OriginEctopic Production of Multiple Hormones (ACTH, MSH and Gastrin) by a Single Malignant TumorCushing's Syndrome in Association with Carcinoma of the Respiratory Tract 1 June 1963Volume 58, Issue 6Page: 993-1002KeywordsAdenocarcinomaAdrenocorticotropic hormoneAttentionBlood plasmaCortisolExcretionHospital medicineLung and intrathoracic tumorsMedical services Issue Published: 1 June 1963 PDF DownloadLoading ...