Long-term medical treatment of ectopic ACTH syndrome.
BACKGROUND
The morbidity of hypercortisolemia due to ectopic production of ACTH by various tumors may be greater than the morbidity of the tumor itself.


METHODS
We report three cases of long-term treatment of ectopic ACTH syndrome due to metastatic bronchial carcinoid, islet cell carcinoma, and malignant thymoma tumors. Clinical and biochemical eucortisolemia was achieved in each case and was sustained from 24 to 55 months. We review the therapeutic options and their reported efficacy.


RESULTS
Cessation of therapy resulted in recurrence of hypercortisolemia in each case, showing the effectiveness of therapy.


CONCLUSIONS
Long-term treatment of ectopic ACTH-induced hypercortisolemia by blocking adrenal steroidogenesis is clinically effective and well tolerated.
Comi
R J
RJ
Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.
Gorden
P
P
D000182:ACTH Syndrome, Ectopic / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D000293:Adolescent; D000308:Adrenocortical Hyperfunction / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D000616:Aminoglutethimide / Q000008:administration & dosage* / Q000009:adverse effects; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008797:Metyrapone / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D012008:Recurrence
D018931:Antineoplastic Agents, Hormonal; D000616:Aminoglutethimide; D008797:Metyrapone