ABSTRACT
In a 53-year-old female patient with typical clinical Cushing's syndrome increased blood sugar levels, hypokalaemia, increased non-dexamethasone suppressable plasma cortisol levels and increased ACTH values in serum were observed. CAT scanning revealed bilateral adrenocortical hyperplasia. The endocrine anterior pituitary function was normal. Radiographically and bronchoscopically a rightsided parahilar tumour was found. Histology showed an atypical metastatic bronchial carcinoid with ectopic ACTH production. Conservative treatment with metyrapone suppressed the Cushing syndrome. The ACTH producing tumour responded to combined chemo- and radiotherapy. The patient is symptom free two years after onset of treatment.
Subject(s)
ACTH Syndrome, Ectopic/complications , Bronchial Neoplasms/complications , Carcinoid Tumor/complications , Cushing Syndrome/etiology , Paraneoplastic Endocrine Syndromes/complications , Carcinoid Tumor/drug therapy , Carcinoid Tumor/pathology , Carcinoid Tumor/radiotherapy , Cushing Syndrome/drug therapy , Cyclophosphamide/therapeutic use , Doxorubicin/therapeutic use , Female , Humans , Lymphatic Metastasis , Metyrapone/therapeutic use , Middle Aged , Vincristine/therapeutic useABSTRACT
In 26 patients with progressive endocrine exophthalmos thyroidectomy was performed after conservative treatment had failed. This treatment was successful in all but two patients. The success of therapy depended on the complete removal of all thyroid tissue. If the ophthalmic changes were more than a year old or if there had been preoperative irradiation of the orbit regression of the exophthalmos was less satisfactory.
Subject(s)
Exophthalmos/radiotherapy , Exophthalmos/surgery , Humans , Orbit , Postoperative Complications , Thyroidectomy/methods , Time FactorsABSTRACT
An anaphylactic shock after multiple injections of the multienzyme compound Neoblastine with the clinical signs of unconsciousness, tachycardia and marked depression of vascular system is reported. Specific antibodies (double diffusion method; 1:32) and an increasing eosinophilia of the peripheral blood up to 36 rel. % have been demonstrated. It must be warned of the application of this compound, the indication of which is extremely doubtful.
