Paradoxical effect of somatostatin analogues on the ectopic secretion of corticotropin in two cases of small cell lung carcinoma.
We investigated 2 patients affected with Cushing's syndrome due to the ectopic production of adrenocorticotropic hormone (ACTH) by a small cell lung carcinoma. In the 2 patients, the long-acting somatostatin analogue octreotide (100 micrograms, subcutaneously) induced a paradoxical increase in plasma ACTH and cortisol levels. In 1 patient, lanreotide, a new somatostatin analogue in a slow-release formulation (30 mg, intramuscularly), induced a similar rise in ACTH and cortisol secretion. To our knowledge, such a response has not been previously reported. Further use of somatostatin analogues in ectopic ACTH-producing tumors, especially lung tumors, requires preliminary evaluation of their therapeutic efficacy by a short test with somatostatin analogue.
Rieu
M
M
Department of Endocrinology, Saint-Michel Hospital, Paris, France.
Rosilio
M
M
Richard
A
A
Vannetzel
J M
JM
Kuhn
J M
JM
D000182:ACTH Syndrome, Ectopic / Q000188:drug therapy* / Q000503:physiopathology; D000328:Adult; D018288:Carcinoma, Small Cell / Q000150:complications / Q000378:metabolism* / Q000556:secondary; D003480:Cushing Syndrome / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D003692:Delayed-Action Preparations; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000652:urine; D008175:Lung Neoplasms / Q000150:complications / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage / Q000009:adverse effects*; D010456:Peptides, Cyclic / Q000008:administration & dosage / Q000009:adverse effects*; D013004:Somatostatin / Q000031:analogs & derivatives*
D003692:Delayed-Action Preparations; D010456:Peptides, Cyclic; C060347:lanreotide; D013004:Somatostatin; D015282:Octreotide; D006854:Hydrocortisone