Rapid Recovery of Hypothalamic-Pituitary Axis after Successful Resection of an ACTH-secreting Neuroendocrine Tumor.
We describe a 30-year-old man with ectopic adrenocorticotropic hormone (ACTH) syndrome. Before the operation, there was no diurnal variation of ACTH, and ACTH did not respond to CRH or dexamethasone suppression tests. These abnormalities disappeared after the removal of a neuroendocrine tumor in the lung. In addition, plasma ACTH was measureable at as early as postoperative day 3 with ACTH levels increasing thereafter. Furthermore, an insulin tolerance test and inferior petrosal sinus sampling indicated that ACTH was secreted from the pituitary. This case indicates that the hypothalamic-pituitary function can recover within a couple of weeks after curative surgery for ectopic ACTH syndrome.
Division of Nephrology and Endocrinology, The University of Tokyo Hospital, Japan.
Yuichi
Y
Takashi
Yuka
Y
Kinoshita
Noriko
N
Makita
Manabu
M
Taguchi
Katsutoshi
K
Takahashi
Masaomi
M
Nangaku
Seiji
S
Fukumoto
D000182:ACTH Syndrome, Ectopic / Q000097:blood / Q000209:etiology*; D000324:Adrenocorticotropic Hormone / Q000097:blood / Q000378:metabolism*; D000328:Adult; D003480:Cushing Syndrome / Q000097:blood; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000378:metabolism* / Q000601:surgery*; D008297:Male; D018358:Neuroendocrine Tumors / Q000097:blood / Q000378:metabolism* / Q000601:surgery*; D017591:Petrosal Sinus Sampling; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome
D000324:Adrenocorticotropic Hormone