Omura M, Sato T, Cho R, Iizuka T, Fujiwara T, Okamoto K, Tashiro Y, Chiba S, Nishikawa T
Department of Medicine, Yokohama Rosai Hospital, Japan.
Cancer. 1994 Sep 1;74(5):1634-9. doi: 10.1002/1097-0142(19940901)74:5<1634::aid-cncr2820740524>3.0.co;2-w.
To the authors' knowledge, there have been no reports describing a case of malignant paraganglioma that produces both adrenocorticotropic hormone (ACTH) and interleukin-6 (IL-6).
The clinical course and pathophysiology of a patient with Cushing's syndrome induced by ectopic ACTH syndrome caused by a cervical malignant paraganglioma with elevated plasma levels of IL-6 was investigated.
Ultrasonography, computed tomography, and magnetic resonance imaging of the neck revealed the presence of a tumor around the area from which the blood sample that showed the highest levels of ACTH and IL-6 was obtained by selective catheterization. Immunohistochemical staining of the removed tissue demonstrated the presence of ACTH and IL-6 proteins in the tumor cells. Reverse transcriptase-polymerase chain reaction also revealed the existence of IL-6 mRNA in those cells.
The malignant paraganglioma of ectopic ACTH syndrome may produce IL-6. The present investigation provides new observations concerning ectopic ACTH syndrome.