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  • Title: A case of pituitary dependent Cushing's disease with clinical and biochemical features of the ectopic ACTH syndrome.
    Author: Hale AC, Millar JB, Ratter SJ, Pickard JD, Doniach I, Rees LH.
    Journal: Clin Endocrinol (Oxf); 1985 Apr; 22(4):479-88. PubMed ID: 2985302.
    Abstract:
    A case of atypical pituitary dependent Cushing's disease is reported. The patient presented with clinical symptoms similar to those of the ectopic ACTH syndrome; notably a marked hypokalaemic alkalosis, widely fluctuating plasma cortisol levels, greatly elevated plasma ACTH levels, and failure to suppress both plasma cortisol and ACTH levels following high dose oral dexamethasone. However, a large aggressive pituitary tumour was detected by skull X-ray and computed tomography. Removal of the pituitary tumour led to full remission of the patient's Cushing's syndrome. Pro-opiomelanocortin (POMC) related peptides in the plasma and tumour tissue extract of this patient have been characterized by gel-filtration and Concanavalin-A Sepharose affinity chromatography, indicating processing of POMC in a manner more usually associated with ectopic tumours.
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