Cushing's syndrome due to ovarian serous adenocarcinoma secreting multiple endocrine substances: a case report and immunohistochemical analysis.

作者信息

Suzuki Takahiro, Ino Kazuhiko, Kikkawa Fumitaka, Shibata Kiyosumi, Kajiyama Hiroaki, Morita Takanori, Nagasaka Tetsuro, Mizutani Shigehiko

机构信息

Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.

出版信息

Gynecol Oncol. 2003 Sep;90(3):662-6. doi: 10.1016/s0090-8258(03)00407-4.

DOI:10.1016/s0090-8258(03)00407-4

PMID:13678742

Abstract

BACKGROUND

Although Cushing's syndrome arises from various neuroendocrine tumors secreting adrenocorticotropin (ACTH) ectopically, ovarian carcinoma rarely causes this syndrome.

CASE

A 66-year-old woman presented with facial swelling and skin pigmentation. She manifested hypercortisolemia, high plasma ACTH, and lack of dexamethasone suppression. MRI showed a solid ovarian tumor and resection of the tumor led to normalization of ACTH and cortisol levels. In addition, elevated serum vasopressin (ADH) and alpha-fetoprotein (AFP) were found, which were also normalized after removal of tumors. Pathological diagnosis was serous adenocarcinoma with neuroendocrine and hepatoid features. Immunohistochemistry detected immunoreactivity of chromogranin A, ACTH, ADH, and AFP in tumor cells.

CONCLUSION

This is a very rare case of successful treatment of Cushing's syndrome arising from an ovarian adenocarcinoma secreting multiple endocrine substances.

摘要