PDF(Pubmed)
Abstract：
Ectopic adrenocorticotropic secretion (EAS) is classically related to small-cell lung cancer but is caused by a wide variety of tumors. In approximately one-fifth of cases, the cause remains unidentified. Excess adrenocorticotropic hormone (ACTH) leads to Cushing\'s syndrome, and the presentation can be due to biochemical derangements such as hypokalemia and hyperglycemia. Alternatively, it may manifest with secondary symptoms such as weight gain, hypertension, skin thinning, abdominal striae, and/or psychotic manifestations. The diagnosis is established through dynamic testing after confirming excess cortisol and ACTH levels. Imaging is then used to identify the hormonally active lesion. Controlling hypercortisolism with steroidogenesis inhibitors is the initial step before proceeding to definitive treatment. Ideally, tumor resection, if possible, but bilateral adrenalectomies are considered in cases not amenable to curative surgery.
摘要：
异位促肾上腺皮质激素（EAS）通常与小细胞肺癌有关，但由多种肿瘤引起。在大约五分之一的案例中，原因仍未查明。过度促肾上腺皮质激素（ACTH）导致库欣综合征，这种表现可能是由于生化紊乱，如低钾血症和高血糖。或者，它可能表现为继发性症状，如体重增加，高血压,皮肤变薄,腹部纹,和/或精神病表现。在确认过量皮质醇和ACTH水平后，通过动态测试确定诊断。然后使用成像来识别激素活性病变。用类固醇生成抑制剂控制皮质醇增多是进行确定性治疗之前的第一步。理想情况下,肿瘤切除,如果可能,但是在不适合治愈性手术的情况下考虑双侧肾上腺切除术。
