Abouibrahim Mahmoud, Rahman Mizanour, Zafar Mansoor, Berliti Stefano, Hacikurt Kadir, Dashora Umesh, Sathiskumar Periasamy
Internal Medicine, Conquest Hospital, East Sussex Healthcare NHS Trust, Hastings, GBR.
Diabetes and Endocrinology, Conquest Hospital, East Sussex healthcare NHS Trust, St Leonards-on-sea, GBR.
Cureus. 2024 Jul 1;16(7):e63619. doi: 10.7759/cureus.63619. eCollection 2024 Jul.
Ectopic adrenocorticotropic secretion (EAS) is classically related to small-cell lung cancer but is caused by a wide variety of tumors. In approximately one-fifth of cases, the cause remains unidentified. Excess adrenocorticotropic hormone (ACTH) leads to Cushing's syndrome, and the presentation can be due to biochemical derangements such as hypokalemia and hyperglycemia. Alternatively, it may manifest with secondary symptoms such as weight gain, hypertension, skin thinning, abdominal striae, and/or psychotic manifestations. The diagnosis is established through dynamic testing after confirming excess cortisol and ACTH levels. Imaging is then used to identify the hormonally active lesion. Controlling hypercortisolism with steroidogenesis inhibitors is the initial step before proceeding to definitive treatment. Ideally, tumor resection, if possible, but bilateral adrenalectomies are considered in cases not amenable to curative surgery.
异位促肾上腺皮质激素分泌（EAS）传统上与小细胞肺癌有关，但可由多种肿瘤引起。在大约五分之一的病例中，病因仍不明。促肾上腺皮质激素（ACTH）过多会导致库欣综合征，其表现可能是由于低钾血症和高血糖等生化紊乱。或者，它可能表现为体重增加、高血压、皮肤变薄、腹部条纹和/或精神症状等继发症状。在确认皮质醇和ACTH水平过高后，通过动态检测来确诊。然后使用影像学检查来识别激素活性病变。在进行确定性治疗之前，用类固醇生成抑制剂控制高皮质醇血症是第一步。理想情况下，如果可能，进行肿瘤切除，但对于不适合根治性手术的病例，考虑双侧肾上腺切除术。
