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Query: UMLS:C0684249 (lung carcinoma)
 23,830 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This report considers the potential usefulness of adrenocorticotropic hormone (ACTH) determinations in diagnosis and in prognosis for therapy of patients with carcinoma of the lung but without clinical Cushing's syndrome. The report is based on radioimmunoassay data from 129 patients, including 62 with lung cancers and 67 with nonmalignant pulmonary conditions. Elevated plasma ACTH was found in 21 of 24 patients with untreated cancer and the hormone was detected in tumor extracts and/or bronchial washings from the remaining 3. Elevation of plasma ACTH was found in only 10 of 38 treated patients. Absence of clinical Cushing's syndrome in spite of high plasma ACTH concentrations is explained by the observation that the predominant form of ectopic ACTH in plasma is immunoreactive but nonbioactive 'big' ACTH. Prolonged survival, for longer than 19 months, was observed in only 5 patients: all patients with low plasma ACTH after resection of the lung tumor and 2 of 3 patients with low plasma ACTH without therapy. ACTH was found in all available malignant tissue, primary and metastatic, from the lung carcinoma group,but not in normal lung or in 5 tumors metastatic to the lung. Of the 39 patients diagnosed initially to have chronic obstructive pulmonary disease, 14 showed plasma ACTH elevation. However, 3 of these patients with the highest concentrations subsequently manifested carcinoma or carcinoma in situ.
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PMID:Ectopic production of big ACTH in carcinoma of the lung. Its clinical usefulness as a biologic marker. 16 43

Endocrine and immunohistochemical studies were performed in a patient with lung cancer associated with gynecomastia. Elevated level of human chorionic gonadotropin (hCG) in plasma and mild hyperadrenocorticism were demonstrated by hormone assays. Postmortem examination proved the existence of anaplastic small cell carcinoma of the lung mixed with a feature of chorioepithelioma. The presence of significant amounts of adrenocorticotropic hormone (ACTH), beta-melanocyte stimulating hormone (beta-MSH), calcitonin, gastrin, hCG, hCG-alpha, hCG-beta and human chorionic somatomammotropin (hCS) in tumor tissues was demonstrated by radioimmunoassays, bioassay and immunohistochemical techniques. We present here a unique case of multiple hormones producing tumor elaborating both hormones of amine precursor uptake and decarboxylation (APUD) series (ACTH, beta-MSH, calcitonin and gastrin) and of placental origin (hCG, hCG-alpha, hCG-beta and hCS).
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PMID:Multiple-hormone producing lung carcinoma. 22 25

This paper describes a case of small cell carcinoma of the lung with ectopic adrenocorticotropic hormone (ACTH) production which presented with mania. The association between manic syndromes and the various forms of glucocorticoid or ACTH excess is discussed.
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PMID:Mania associated with small cell carcinoma of the lung. 284 Aug 87

The role of radioimmunoassay (RIA) in the diagnosis and management of endocrine tumors, such as pituitary tumors, insulinomas, and gastrinomas, has long been well established. A variety of nonendocrine tumors are capable of elaborating one or more humoral substances that resemble immunologically well-known, well-characterized biologically active hormones or their prohormone precursors or metabolic products. The possible value of mass screening for carcinoma of the lung by the detection of precursor adrenocorticotropic hormone (ACTH) in plasma was tested. However, the usefulness was limited by the potential for false-positive, i.e., elevation of marker concentration in the plasma of heavy smokers even in the absence of invasive carcinoma. Although on occasion a dramatic decrease of plasma ACTH after surgical resection or on some chemotherapeutic schedules has been observed, this does not occur with sufficient regularity to serve definitely as an objective measure of efficacy of therapy. The limitations of nonhormonal tumor markers, such as carcinoembryonic antigen (CEA), are also considered.
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PMID:The society of Surgical Oncology Lucy Wortham James Research Award 1983. Radioimmunoassay in oncology. 631 63

This report describes a 63-yr-old man with lung cancer accompanying hypertension, hyperpigmentation, muscle weakness, psychosis, hypokalemia, hyperglycemia, hyponatremia, massive natriuresis and lower serum osmolality than urine osmolality. Elevated levels of plasma and urine corticosteroids and of plasma immunoreactive adrenocorticotropic hormone (ACTH) were not altered by the administration of large amounts of dexamethasone. Elevated plasma antidiuretic hormone (ADH) values were also demonstrated. Postmortem examinations revealed small cell lung carcinoma with extensive metastasis, bilateral adrenocortical hyperplasia and Crooke's degeneration of the pituitary gland. Immunoradiological and immunohistochemical studies demonstrated the presence of immunoreactive ACTH, ADH and gastrin-releasing peptide in the tumor tissue. Beta-melanocyte-stimulating hormone, calcitonin and carcinoembryonic antigen were also detected by one of the methods. Hence, this is a rare case of lung cancer with multiple hormone production and clinical and laboratory evidence of both the ectopic ACTH and ADH syndromes.
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PMID:Small cell lung carcinoma with ectopic adrenocorticotropic hormone and antidiuretic hormone syndromes: a case report. 632 89

To correlate serial biomarkers and disease activity in carcinoma of the lung, carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), adrenocorticotropic hormone (ACTH), C3-derived protein (C3DP-C), and LDH were assayed in 43 patients with small cell lung carcinoma (SCLC) and in 20 patients with non-small cell lung cancer (NSCLC) (15 with adenocarcinoma, three with squamous cell carcinoma, and two with mixed histology). Disease status after treatment was rated as one of the following: complete response, partial response, minor regression, stable disease, and progressive disease. Significant correlations between disease status and markers in SCLC were found for CEA, NSE, LDH, and ACTH. In NSCLC, only CEA and LDH showed significant correlation. Marker-marker correlations were significant in SCLC for CEA and NSE (P less than 0.05), CEA and LDH (P = 0.01), and NSE and LDH (P less than 0.01); in NSCLC none were significant. None of the markers exhibited significant correlations with specific metastatic sites. Certain biomarkers (CEA, NSE, and LDH in SCLC; CEA and LDH in NSCLC) can be used alone or in combination to monitor disease activity but appear to be no more sensitive than standard clinical investigational methods.
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PMID:Multiple sequential biomarkers in monitoring patients with carcinoma of the lung. 632 8

We investigated 2 patients affected with Cushing's syndrome due to the ectopic production of adrenocorticotropic hormone (ACTH) by a small cell lung carcinoma. In the 2 patients, the long-acting somatostatin analogue octreotide (100 micrograms, subcutaneously) induced a paradoxical increase in plasma ACTH and cortisol levels. In 1 patient, lanreotide, a new somatostatin analogue in a slow-release formulation (30 mg, intramuscularly), induced a similar rise in ACTH and cortisol secretion. To our knowledge, such a response has not been previously reported. Further use of somatostatin analogues in ectopic ACTH-producing tumors, especially lung tumors, requires preliminary evaluation of their therapeutic efficacy by a short test with somatostatin analogue.
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PMID:Paradoxical effect of somatostatin analogues on the ectopic secretion of corticotropin in two cases of small cell lung carcinoma. 831 5

To determine the neuroendocrine (NE) features of thymic epithelial tumor, immunohistochemistry and electron microscopy studies were performed on eight NE tumors (thymic carcinoids) and 26 non-NE tumors (nine thymic carcinomas, five atypical thymomas, and 12 thymomas other than lymphocytic thymoma). Immunohistochemical studies were performed with antibodies against general markers for NE cells (synaptophysin, alpha subunit of a guanine nucleotide-binding protein, Go, and small-cell lung carcinoma cluster 1 antigen), and a broad panel of antibodies for hormonal substances. Thymic carcinoid showed synchronous diffuse immunoreactivity for the three NE markers and contained cells that were positive for a variety of hormonal products: human chorionic gonadotropin (hCG) alpha-subunit (eight of eight), hCG beta-subunit (three of eight), adrenocorticotropic hormone (ACTH) (three of eight), calcitonin (two of eight), calcitonin gene-related peptide (two of eight), and serotonin (one of eight). Conversely, although positivity for NE markers was neither synchronous nor diffuse in non-NE tumors, seven of nine thymic carcinomas, three of five atypical thymomas (focal or dispersed distribution), and none of the five thymomas were positive for at least two of these NE markers. A small number of neoplastic cells were positive for hCGalpha-subunit or ACTH in three thymic carcinomas and one atypical thymoma. Ultrastructurally, dense core granules (DCG) were much more frequent in thymic carcinoid, but several DCG-like granules were identified in 12 of 13 non-NE tumors with or without immunoexpression of NE markers. The presence of focal or dispersed NE cells in thymic carcinoma and atypical thymoma may reflect multidirectional differentiation within the tumor, which, like cytological atypia, epithelial CD5 expression, and lack of immature T cell infiltration, may be another feature of this group at thymic tumors.
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PMID:Neuroendocrine differentiation in thymic epithelial tumors with special reference to thymic carcinoma and atypical thymoma. 956 81

Cushing syndrome (CS) caused by ectopic adrenocorticotropic hormone (ACTH) production (EA) poses major challenges diagnostically by mimicking the pituitary-dependent form of CS and therapeutically by producing severe, life-threatening hypercortisolemia. This retrospective follow-up study describes the clinical characteristics and course of EA in a large referral center. Computer-based cross-index codes for EA, CS, and bilateral adrenalectomy were used to identify patients treated at the Mayo Clinic between 1956 and 1998. EA was confirmed in 106 patients. Gender distribution showed a slight female predominance (61:45). Bronchial carcinoid was the most frequent cause of EA (25%), followed by islet cell cancer (16%), small-cell lung carcinoma (11%), medullary thyroid cancer (8%), disseminated neuroendocrine tumor of unknown primary source (7%), thymic carcinoid (5%), pheochromocytoma (3%), disseminated gastrointestinal carcinoid (1%), and other tumors (8%). No tumor was found in 16% of patients. Altogether, 28 patients were managed medically, and the others underwent curative tumor resection (13 patients) or bilateral adrenalectomy (65 patients). Surgically treated patients had longer survival, but this was most likely affected by treatment bias. The diagnoses of CS and ACTH-secreting neoplasm were usually concurrent, although, there were remarkable cases in which the two conditions were diagnosed several years apart. Curative resection of the tumor producing EA was possible in a small proportion of patients (12%). When curative resection is not possible, patients who are reasonable surgical candidates are likely to benefit from adrenalectomy. Additional experience with bilateral laparoscopic adrenalectomy should increase the number of patients who benefit from adrenal-directed surgery.
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PMID:Cushing syndrome due to ectopic adrenocorticotropic hormone secretion. 1157 35

Secretion of ectopic adrenocorticotropic hormone (ACTH) with consequently Cushing's syndrome is a rare paraneoplastic phenomenon. It has been described in a variety of malignancies, like bronchial carcinoids, small-cell lung carcinoma, thymoma, pancreatic carcinoma and other. In many cases of suspected ectopic ACTH secretion, it is difficult to histologically or cytochemically confirm the diagnosis. We present a 63-year-old woman with a recurrent poorly differentiated squamous cell lung carcinoma with clinical and biochemical features consistent with ectopic Cushing's syndrome. Immunocytochemical staining confirmed the secretion of ACTH by tumour cells.
Lung Cancer 2006 Feb
PMID:A case of recurrent non-small-cell lung carcinoma and paraneoplastic Cushing's syndrome. 1635 72


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