Ectopic Cushing syndrome in Colombia
Arch. endocrinol. metab. (Online)
;
64(6): 687-694, Nov.-Dec. 2020. tab, graf
Article
Dans Anglais
| LILACS
| ID: biblio-1142207
ABSTRACT
ABSTRACT Objective The aim was to describe the clinical features of patients with ectopic Cushing syndrome (ECS) from Colombia and compare these findings with other series to provide the best management for these patients. Materials and methods Records of patients with ECS from 1986 to 2017 were retrospectively reviewed; patients with a diagnosis of adrenal or pituitary Cushing syndrome (CS) were excluded. Results Fourteen patients with ECS were analyzed in this study. The mean age was 54.4 (SD 17.1) years, and the female to male ratio was 1.331. Regarding the etiology of ECS, four patients had lung carcinoids (28.6%), three had small-cell lung carcinoma (21.4%), three had pancreatic neuroendocrine tumors (21.4%), one had medullary thyroid cancer (7.1%), one had non-metastatic pheochromocytoma (7.1%), one had metastatic thymoma (7.1%) and one patient had an occult source of ACTH (7.1%). The most common clinical features at presentation were moon-face, muscle weakness, diabetes mellitus and hypertension. Hyperpigmentation was present in 36% of patients, and 12 patients had hypokalemia with a mean value of 2.3 mEq/L (SD 0.71). The median basal cortisol, 24-hour urinary free cortisol (UFC) and ACTH were 30.5 ug/dL (IQR 21-59 ug/dL), 2,600 ug/24 h (IQR 253-6,487 ug/24 h) and 91 pg/mL (IQR 31.9-141.9), respectively. Thirteen patients (92.8%) had the site of the primary lesion identified. Six patients had undergone a surgical intervention to address the primary tumor. Resection was curative in 28.5% of patients. Death occurred in 57.1% of patients, and the median overall survival was 27 months. Intrathoracic tumors had the most aggressive behavior. Conclusions ECS is a rare disease; however, it is associated with high morbidity and mortality. A rapid intervention supported by an interdisciplinary group is required to improve overall survival and quality of life
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Syndrome de sécrétion ectopique d'ACTH
/
Syndrome de Cushing
Type d'étude:
Étude pronostique
Limites du sujet:
Femelle
/
Humains
/
Mâle
Pays comme sujet:
Amérique du Sud
/
Colombie
langue:
Anglais
Texte intégral:
Arch. endocrinol. metab. (Online)
Thème du journal:
Endocrinologie
/
Métabolisme
Année:
2020
Type:
Article
Pays d'affiliation:
Colombie
/
États-Unis d'Amérique
Institution/Pays d'affiliation:
Universidad Pontificia Bolivariana/CO
/
Universidad de Antioquia/CO
/
Universidad de Nariño/CO
/
Universidad de Texas/US
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