Ectopic ACTH Cushing's syndrome: V3 vasopressin receptor but not CRH receptor gene expression in a pulmonary carcinoid tumor

Details

Serval ID
serval:BIB_725943CE7BFD
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Ectopic ACTH Cushing's syndrome: V3 vasopressin receptor but not CRH receptor gene expression in a pulmonary carcinoid tumor
Journal
Horm Res
Author(s)
Chabot  V., de Keyzer  Y., Gebhard  S., Uske  A., Bischof-Delaloye  A., Rey  F., Dusmet  M., Gomez  F.
ISSN
0301-0163
Publication state
Published
Issued date
1998
Peer-reviewed
Oui
Volume
50
Number
4
Pages
226-31
Notes
Case Reports
Research Support, Non-U.S. Gov't
Chabot, V
de Keyzer, Y
Gebhard, S
Uske, A
Bischof-Delaloye, A
Rey, F
Dusmet, M
Gomez, F
Switzerland
Hormone research
Horm Res. 1998;50(4):226-31.
Abstract
In the etiological diagnosis of ACTH-dependent Cushing's syndrome, it may be difficult to distinguish pituitary disease from ectopic ACTH production, specially when this is due to a benign neuroendocrine tumor. We describe a patient with partial dexamethasone suppression consistent with Cushing's disease, an absent response to CRH suggesting ectopic ACTH production and an atypical, apparent circadian rhythm. Bilateral cavernous sinus catheterization suggested a nonpituitary source of ACTH and, in the search of an ectopic tumor, somatostatin receptor scintigraphy, abdominal CT scan, and duodenopancreatic endoscopic echography were performed and failed to reveal any abnormality. Thoracic CT scan disclosed a tiny right lung nodule that showed a definite tracer uptake on MIBG scintigraphy. After resection, the nodule proved to be an 8-mm typical pulmonary carcinoid, with positive immunostaining for the classical neuroendocrine markers and for ACTH, and showing tissue expression of the POMC gene. However, the CRH receptor gene was not expressed, explaining the absent CRH response in vivo, whereas the V3 vasopressin receptor gene was expressed in the tumor tissue. The latter feature appears to be characteristic of benign carcinoids and may contribute to explaining the CRH-independent circadian rhythm observed in this case.
Keywords
ACTH Syndrome, Ectopic/*complications Aged Carcinoid Tumor/chemistry/*complications/diagnosis Cushing Syndrome/*etiology Female Gene Expression Humans Lung Neoplasms/chemistry/*complications/diagnosis Receptors, Corticotropin-Releasing Hormone/*genetics Receptors, Vasopressin/*genetics Reverse Transcriptase Polymerase Chain Reaction
Pubmed
Web of science
Create date
10/04/2008 16:52
Last modification date
20/08/2019 14:30
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