Via practica 1/2010

Cushing‘s syndrome as a manifestation of generalized gastric carcinoid

Cushing‘s syndrome occurs as a result of autonomous overproduction of glucocorticoids. Primary Cushing‘s syndrome is caused by glucocorticoid overproduction by an adenoma, carcinoma, or adrenal hyperplasia. ACTH secretion is suppressed. In the case of secondary Cushing‘s syndrome, there is primary ACTH overproduction in the hypothalamic-pituitary region or ectopically. The level of ACTH is normal or high. Ectopic overproduction is less common, the sources most typically include small-cell lung carcinoma and thymoma, less frequently carcinoids and other malignancies. The incidence of carcinoids ranges from 0.7 to 2.1 per 100,000 people. Although they more commonly occur in the area of the gastrointestinal tract than in the lungs or bronchi, gastrointestinal carcinoids cause ACTH overproduction less frequently than lung carcinoids. Gastric carcinoid is a rarely occurring endocrine tumour of the gastrointestinal tract, often lacking clinical manifestation. A generalized gastric carcinoid was the cause of Cushing‘s syndrome in an 80-year-old female patient.

Keywords: Cushing‘s syndrome, gastric carcinoid, ACTH overproduction