Ectopic Cushing syndrome

Definition

Ectopic Cushing syndrome is a form of Cushing syndrome in which a tumor outside the pituitary gland produces a hormone called adrenocorticotropic hormone (ACTH).

Causes

Cushing syndrome is a disorder that occurs when your body has a higher than normal level of the hormone cortisol. This hormone is made in the adrenal glands. Too much cortisol can be due to various problems. One of the causes is if there is too much of the hormone ACTH in the blood. ACTH is usually made by the pituitary in small amounts and then signals the adrenal glands to produce cortisol. Sometimes other cells outside the pituitary can make large amounts of ACTH. This is called ectopic Cushing syndrome. Ectopic means that something is occurring in an abnormal place in the body.

Ectopic Cushing syndrome is caused by tumors that release ACTH. Tumors that can, in rare cases, release ACTH include:

Symptoms

Ectopic Cushing syndrome can cause a lot of different symptoms. Some people have many symptoms while others have only a few. Most people with any type of Cushing syndrome have:

Skin changes that are often seen:

Muscle and bone changes include:

Body-wide (systemic) problems may include:

Women may have:

Men may have:

Other symptoms that may occur include:

Exams and Tests

The health care provider will perform a physical exam and ask about your symptoms.

Tests that may be done include:

Treatment

The best treatment for ectopic Cushing syndrome is surgery to remove the tumor. Surgery is usually possible when the tumor is noncancerous (benign).

In some cases, the tumor is cancerous and spreads to other areas of the body before the doctor can discover the problem with cortisol production. Surgery may not be possible in these cases. But the doctor may prescribe medicines to block cortisol production.

Sometimes removal of both adrenal glands is needed if the tumor cannot be found and medicines do not fully block cortisol production.

Outlook (Prognosis)

Surgery to remove the tumor may lead to full recovery. But there is a chance that the tumor will come back.

Possible Complications

The tumor may spread or return after surgery. A high cortisol level may continue.

When to Contact a Medical Professional

Call your provider if you develop symptoms of Cushing syndrome.

Prevention

Prompt treatment of tumors may reduce the risk in some cases. Many cases are not preventable.


Review Date: 5/6/2019
Reviewed By: Brent Wisse, MD, board certified in Metabolism/Endocrinology, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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