Mifepristone for ectopic ACTH secretion in metastatic endocrine carcinomas: report of two cases.
Ectopic adrenocorticotropin secretion (EAS) remains a therapeutic challenge whenever the tumor responsible for the syndrome is not amenable to curative resection. Two cases of EAS related to metastatic foregut-derived endocrine carcinomas led us to use mifepristone, an antagonist of both progesterone and glucocorticoids. Mifepristone clearly improved skin lesions and diabetes associated with hypercorticism. The beneficial effect lasted for about 10 months. In both cases, recurrent hypertension and hypokalemia eventually required adrenalectomy.
Cassier
Philippe A
PA
Unité de Jour d'Oncologie Médicale Multidisciplinaire, Hôpital Edouard Herriot, Lyon, France.
Abou-Amara-Olivieri
Sawsan
S
Artru
Pascal
P
Lapalus
Marie-George
MG
Riou
Jean-Paul
JP
Lombard-Bohas
Catherine
C
D000182:ACTH Syndrome, Ectopic / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D000328:Adult; D018278:Carcinoma, Neuroendocrine / Q000150:complications / Q000473:pathology*; D004064:Digestive System / Q000473:pathology; D005260:Female; D006727:Hormone Antagonists / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008875:Middle Aged; D015735:Mifepristone / Q000627:therapeutic use*; D009362:Neoplasm Metastasis; D011188:Potassium / Q000097:blood
D006727:Hormone Antagonists; D015735:Mifepristone; D011188:Potassium; D006854:Hydrocortisone