caa a22 4500 465803814 CHVBK 20180323112058.0 cr unu---uuuuu 170327e19900601xx s 000 0 eng 10.1007/BF03348619 doi (NATIONALLICENCE)springer-10.1007/BF03348619 A case of pseudo-Nelson's syndrome: cure of ACTH hypersecretion by removal of a bronchial carcinoid tumor responsible for Cushing's syndrome [Elektronische Daten] [Jean-Daniel Lalau, D. Vieau, F. Tenenbaum, P. Westeel, A. Mesmacque, F. Lenne, J. Quichaud] It may sometimes be difficult to distinguish Cushing's disease from ectopic ACTH syndrome. A case is described here of a patient with a Cushing's syndrome and diagnostic difficulties. Initial features were consistent with a Cushing's disease (in particular metopirone test was positive). Because of relapse of hypercortisolism after mitotane therapy, total adrenalectomy was performed. Thereafter features occurred that evoked Nelson's syndrome, including high plasma ACTH levels and a pituitary mass syndrome. Pituitary reserve testings by vasopressin or cortico-tropin-releasing factor were positive, although inconstantly, in that plasma ACTH increased. A lung tumor was discovered about 20 yr after the first clinical signs of hypercortisolism. Its removal led to the discovery of a bronchial carcinoid tumor and was followed by normalization of plasma ACTH levels. An analysis of proopiomelanocortin-related peptides was performed postoperatively on the blood drawn before and after the tumor resection and on the tumor; the results of this study would have been contributive to the diagnosis of occult ectopic ACTH tumor. In conclusion this case demonstrates the limitations of the conventional procedures in the diagnosis of the ectopic ACTH syndrome. At contrast the newer biochemical procedures may be very useful in determining the type of hypercortisolism. Italian Society of Endocrinology (SIE), 1990 Ectopic ACTH syndrome nationallicence Nelson's syndrome nationallicence ectopic tumor nationallicence proopiomelanocortin nationallicence Cushing's syndrome nationallicence Lalau Jean-Daniel Service de Médecine Interne, Endocrinologie, Centre Hospitalier Régional, BP 3009, 80030, Amiens Cedex, France aut Vieau D. Centre de Récherches sur les Maladies Endocriniennes, Hôpital Cochin, Paris, France aut Tenenbaum F. Service de Médecine Interne, Endocrinologie, Centre Hospitalier Régional, BP 3009, 80030, Amiens Cedex, France aut Westeel P. Service de Médecine Interne, Endocrinologie, Centre Hospitalier Régional, BP 3009, 80030, Amiens Cedex, France aut Mesmacque A. Service de Médecine Interne, Endocrinologie, Centre Hospitalier Régional, BP 3009, 80030, Amiens Cedex, France aut Lenne F. Centre de Récherches sur les Maladies Endocriniennes, Hôpital Cochin, Paris, France aut Quichaud J. Service de Médecine Interne, Endocrinologie, Centre Hospitalier Régional, BP 3009, 80030, Amiens Cedex, France aut Journal of Endocrinological Investigation Springer International Publishing 13/6(1990-06-01), 531-537 0391-4097 13:6<531 1990 13 40618 https://doi.org/10.1007/BF03348619 text/html Onlinezugriff via DOI 1 brief-communication jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF03348619 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lalau Jean-Daniel Service de Médecine Interne, Endocrinologie, Centre Hospitalier Régional, BP 3009, 80030, Amiens Cedex, France aut NATIONALLICENCE 700 1- Vieau D. Centre de Récherches sur les Maladies Endocriniennes, Hôpital Cochin, Paris, France aut NATIONALLICENCE 700 1- Tenenbaum F. Service de Médecine Interne, Endocrinologie, Centre Hospitalier Régional, BP 3009, 80030, Amiens Cedex, France aut NATIONALLICENCE 700 1- Westeel P. Service de Médecine Interne, Endocrinologie, Centre Hospitalier Régional, BP 3009, 80030, Amiens Cedex, France aut NATIONALLICENCE 700 1- Mesmacque A. Service de Médecine Interne, Endocrinologie, Centre Hospitalier Régional, BP 3009, 80030, Amiens Cedex, France aut NATIONALLICENCE 700 1- Lenne F. Centre de Récherches sur les Maladies Endocriniennes, Hôpital Cochin, Paris, France aut NATIONALLICENCE 700 1- Quichaud J. Service de Médecine Interne, Endocrinologie, Centre Hospitalier Régional, BP 3009, 80030, Amiens Cedex, France aut NATIONALLICENCE 773 0- Journal of Endocrinological Investigation Springer International Publishing 13/6(1990-06-01), 531-537 0391-4097 13:6<531 1990 13 40618 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer