Cushing's Syndrome due to a Pancreatic neuroendocrine tumor metastatic to the ovaries: A clinicopathological description of a case

Stefano La Rosa, Alessandro Marando, Fabio Ghezzi, Paolo Colombo, Giovanna Finzi, Carlo Capella

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

We report the case of a 36-year-old woman with Cushing's syndrome caused by a malignant unresectable neuroendocrine carcinoma of the pancreas that developed bilateral ovarian metastases 7 years after diagnosis. In November 2001, because of abdominal pain and jaundice, the patient underwent radiological investigations and exploratory laparotomy that demonstrated the presence of a 3-cm mass of the head of the pancreas, infiltrating the superior mesenteric vein, associated with enlargement of multiple abdominal lymph nodes and with a liver nodule. Histological examination of one lymph node and of the liver nodule demonstrated the presence of metastases from a well-differentiated neuroendocrine carcinoma showing corticotropin immunoreactivity. A few months later, the patient started to show the clinical symptoms of Cushing's syndrome and underwent steroid-blocking ketoconazole therapy. The clinical endocrine picture was controlled until the end of 2008, when the endocrine symptoms of the Cushing's syndrome worsened and bilateral ovarian tumors appeared. Hysteroannexectomy was performed and ovarian tumors were found to be metastases from a well-differentiated neuroendocrine carcinoma with morphological and immunohistochemical features overlapping those observed in 2002. The clinical situation worsened and the patient died in November 2009. The clinical aspects and the problems in the differential diagnosis are discussed.

Original languageEnglish
Pages (from-to)118-124
Number of pages7
JournalEndocrine Pathology
Volume22
Issue number2
DOIs
Publication statusPublished - Jun 2011

Fingerprint

Neuroendocrine Carcinoma
Neuroendocrine Tumors
Cushing Syndrome
Ovary
Neoplasm Metastasis
Pancreas
Lymph Nodes
Mesenteric Veins
Ketoconazole
Liver
Jaundice
Adrenocorticotropic Hormone
Laparotomy
Abdominal Pain
Neoplasms
Differential Diagnosis
Steroids
Therapeutics

Keywords

  • ACTH
  • Cushing' syndrome
  • Ectopic secretion
  • Neuroendocrine tumor
  • Pancreas

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Cushing's Syndrome due to a Pancreatic neuroendocrine tumor metastatic to the ovaries : A clinicopathological description of a case. / La Rosa, Stefano; Marando, Alessandro; Ghezzi, Fabio; Colombo, Paolo; Finzi, Giovanna; Capella, Carlo.

In: Endocrine Pathology, Vol. 22, No. 2, 06.2011, p. 118-124.

Research output: Contribution to journalArticle

La Rosa, Stefano ; Marando, Alessandro ; Ghezzi, Fabio ; Colombo, Paolo ; Finzi, Giovanna ; Capella, Carlo. / Cushing's Syndrome due to a Pancreatic neuroendocrine tumor metastatic to the ovaries : A clinicopathological description of a case. In: Endocrine Pathology. 2011 ; Vol. 22, No. 2. pp. 118-124.
@article{2a67936f1e0940a39b2bbc1328870979,
title = "Cushing's Syndrome due to a Pancreatic neuroendocrine tumor metastatic to the ovaries: A clinicopathological description of a case",
abstract = "We report the case of a 36-year-old woman with Cushing's syndrome caused by a malignant unresectable neuroendocrine carcinoma of the pancreas that developed bilateral ovarian metastases 7 years after diagnosis. In November 2001, because of abdominal pain and jaundice, the patient underwent radiological investigations and exploratory laparotomy that demonstrated the presence of a 3-cm mass of the head of the pancreas, infiltrating the superior mesenteric vein, associated with enlargement of multiple abdominal lymph nodes and with a liver nodule. Histological examination of one lymph node and of the liver nodule demonstrated the presence of metastases from a well-differentiated neuroendocrine carcinoma showing corticotropin immunoreactivity. A few months later, the patient started to show the clinical symptoms of Cushing's syndrome and underwent steroid-blocking ketoconazole therapy. The clinical endocrine picture was controlled until the end of 2008, when the endocrine symptoms of the Cushing's syndrome worsened and bilateral ovarian tumors appeared. Hysteroannexectomy was performed and ovarian tumors were found to be metastases from a well-differentiated neuroendocrine carcinoma with morphological and immunohistochemical features overlapping those observed in 2002. The clinical situation worsened and the patient died in November 2009. The clinical aspects and the problems in the differential diagnosis are discussed.",
keywords = "ACTH, Cushing' syndrome, Ectopic secretion, Neuroendocrine tumor, Pancreas",
author = "{La Rosa}, Stefano and Alessandro Marando and Fabio Ghezzi and Paolo Colombo and Giovanna Finzi and Carlo Capella",
year = "2011",
month = "6",
doi = "10.1007/s12022-011-9153-z",
language = "English",
volume = "22",
pages = "118--124",
journal = "Endocrine Pathology",
issn = "1046-3976",
publisher = "Humana Press",
number = "2",

}

TY - JOUR

T1 - Cushing's Syndrome due to a Pancreatic neuroendocrine tumor metastatic to the ovaries

T2 - A clinicopathological description of a case

AU - La Rosa, Stefano

AU - Marando, Alessandro

AU - Ghezzi, Fabio

AU - Colombo, Paolo

AU - Finzi, Giovanna

AU - Capella, Carlo

PY - 2011/6

Y1 - 2011/6

N2 - We report the case of a 36-year-old woman with Cushing's syndrome caused by a malignant unresectable neuroendocrine carcinoma of the pancreas that developed bilateral ovarian metastases 7 years after diagnosis. In November 2001, because of abdominal pain and jaundice, the patient underwent radiological investigations and exploratory laparotomy that demonstrated the presence of a 3-cm mass of the head of the pancreas, infiltrating the superior mesenteric vein, associated with enlargement of multiple abdominal lymph nodes and with a liver nodule. Histological examination of one lymph node and of the liver nodule demonstrated the presence of metastases from a well-differentiated neuroendocrine carcinoma showing corticotropin immunoreactivity. A few months later, the patient started to show the clinical symptoms of Cushing's syndrome and underwent steroid-blocking ketoconazole therapy. The clinical endocrine picture was controlled until the end of 2008, when the endocrine symptoms of the Cushing's syndrome worsened and bilateral ovarian tumors appeared. Hysteroannexectomy was performed and ovarian tumors were found to be metastases from a well-differentiated neuroendocrine carcinoma with morphological and immunohistochemical features overlapping those observed in 2002. The clinical situation worsened and the patient died in November 2009. The clinical aspects and the problems in the differential diagnosis are discussed.

AB - We report the case of a 36-year-old woman with Cushing's syndrome caused by a malignant unresectable neuroendocrine carcinoma of the pancreas that developed bilateral ovarian metastases 7 years after diagnosis. In November 2001, because of abdominal pain and jaundice, the patient underwent radiological investigations and exploratory laparotomy that demonstrated the presence of a 3-cm mass of the head of the pancreas, infiltrating the superior mesenteric vein, associated with enlargement of multiple abdominal lymph nodes and with a liver nodule. Histological examination of one lymph node and of the liver nodule demonstrated the presence of metastases from a well-differentiated neuroendocrine carcinoma showing corticotropin immunoreactivity. A few months later, the patient started to show the clinical symptoms of Cushing's syndrome and underwent steroid-blocking ketoconazole therapy. The clinical endocrine picture was controlled until the end of 2008, when the endocrine symptoms of the Cushing's syndrome worsened and bilateral ovarian tumors appeared. Hysteroannexectomy was performed and ovarian tumors were found to be metastases from a well-differentiated neuroendocrine carcinoma with morphological and immunohistochemical features overlapping those observed in 2002. The clinical situation worsened and the patient died in November 2009. The clinical aspects and the problems in the differential diagnosis are discussed.

KW - ACTH

KW - Cushing' syndrome

KW - Ectopic secretion

KW - Neuroendocrine tumor

KW - Pancreas

UR - http://www.scopus.com/inward/record.url?scp=80051704272&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80051704272&partnerID=8YFLogxK

U2 - 10.1007/s12022-011-9153-z

DO - 10.1007/s12022-011-9153-z

M3 - Article

C2 - 21390554

AN - SCOPUS:80051704272

VL - 22

SP - 118

EP - 124

JO - Endocrine Pathology

JF - Endocrine Pathology

SN - 1046-3976

IS - 2

ER -