title: Ectopic ACTH syndrome due to Grawitz tumor.
abstract: An extremely unusual case of adrenocorticotropin (ACTH)-producing Grawitz tumor is reported in a 56-year-old female. The clinical feature of the patient was compatible with Cushing's syndrome. The plasma levels of ACTH and cortisol were markedly elevated. At autopsy, a left renal tumor was demonstrated and its histopathological diagnosis was renal cell carcinoma (Grawitz tumor). The adrenal gland was bilaterally enlarged with diffuse hyperplasia of the fasciculate zone. The adenohypophyseal cells were atrophic and showed Crooke's degeneration. The tumor contained extremely high levels of ACTH, beta-lipotropin and beta-endorphin. The presence of large molecular weight forms of ACTH has also been demonstrated by a Sephadex G-50 gel filtration of the tumor extract. We authors believe that this is the first documented case of ACTH-producing Grawitz tumor in the literature.
authors.affiliation: Third Department of Internal Medicine, Hirosaki University School of Medicine, Aomori, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Watanobe
authors.forename: M
authors.initials: M
authors.lastname: Yoshioka
authors.forename: K
authors.initials: K
authors.lastname: Takebe
mesh_terms: D000182:ACTH Syndrome, Ectopic / Q000209:etiology* / Q000652:urine; D000324:Adrenocorticotropic Hormone / Q000032:analysis; D002292:Carcinoma, Renal Cell / Q000378:metabolism*; D002850:Chromatography, Gel; D005260:Female; D006801:Humans; D008875:Middle Aged; D009384:Paraneoplastic Endocrine Syndromes / Q000209:etiology*; D011863:Radioimmunoassay; D001615:beta-Endorphin / Q000032:analysis; D008083:beta-Lipotropin / Q000032:analysis
chemical_list: D001615:beta-Endorphin; D000324:Adrenocorticotropic Hormone; D008083:beta-Lipotropin