Cushing's syndrome with a large pituitary adenoma producing both corticotropin-releasing hormone (CRH) and adrenocorticotropin (ACTH).
A 57-year-old man showed high serum cortisol, plasma adrenocorticotropin (ACTH) and corticotropin-releasing hormone (CRH) levels with a large pituitary tumor and a prostatic cancer. High dose dexamethasone did not suppress cortisol secretion and CRH administration did not stimulate cortisol secretion. After surgical removal of the pituitary tumor, plasma CRH, ACTH and serum cortisol levels were normalized. Histological examinations showed pituitary adenoma and prostatic adenocarcinoma, and pituitary adenoma was stained with both anti-CRH and anti-ACTH antibodies, but prostatic cancer was not stained. A CRH-producing pituitary adenoma is a new type of Cushing's syndrome.
Department of Internal Medicine, Tokushima Municipal Hospital.
Yuya
Y
Yamada
Akiko
A
Ohashi
Toru
T
Inoue
Katsuhiko
K
Sakaguchi
Takahiro
T
Tsujimura
Daisuke
D
Okamoto
Hiroaki
H
Itatani
Naomi
N
Fujimoto
Kazumasa
K
Kusaka
Hisako
H
Fushimi
D000230:Adenocarcinoma / Q000150:complications; D000236:Adenoma / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism* / Q000601:surgery; D000324:Adrenocorticotropic Hormone / Q000096:biosynthesis* / Q000097:blood; D003346:Corticotropin-Releasing Hormone / Q000096:biosynthesis* / Q000097:blood; D003480:Cushing Syndrome / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D003907:Dexamethasone; D005938:Glucocorticoids; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007016:Hypophysectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism* / Q000601:surgery; D010912:Pituitary-Adrenal Function Tests; D011471:Prostatic Neoplasms / Q000150:complications
D005938:Glucocorticoids; D003907:Dexamethasone; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone