Ectopic Cushing syndrome is a form of
Other forms of Cushing syndrome include:
Cushing disease Cushing syndrome caused by adrenal tumor Exogenous Cushing syndrome
Cushing syndrome – ectopic; Ectopic ACTH syndrome
Ectopic Cushing syndrome, on the other hand, occurs when ACTH is produced somewhere other than the pituitary gland. Ectopic means occurring in an abnormal place.
Ectopic Cushing syndrome is caused by tumors that release ACTH. Tumors that can, in rare cases, release ACTH include:
- Benign carcinoid tumors of the lung
Islet cell tumorsof the pancreas Medullary carcinoma of the thyroid
- Small cell tumors of the lung
- Tumors of the thymus gland
Ectopic Cushing syndrome tends to have fewer symptoms than classic Cushing syndrome. Most people with Cushing syndrome have:
- Round, red, and full face (
- Slow growth rate in children
- Weight gain with fat accumulation on the trunk, but fat loss from the arms, legs, and buttocks (central
Skin changes that are often seen:
- Skin infections
- Purple marks (1/2 inch or more wide) called striae on the skin of the abdomen, thighs, and breasts
- Thin skin with easy bruising
Muscle and bone changes include:
- Backache, which occurs with routine activities
- Bone pain or tenderness
- Collection of fat between the shoulders and above the collar bone
- Rib and spine fractures caused by thinning of the bones
- Weak muscles, especially of the hips and shoulders
Women may have:
- Excess hair growth on the face, neck, chest, abdomen, and thighs
- Periods that become irregular or stop
Men may have:
- Decreased or no desire for sex
Other symptoms that may occur include:
Mental changes, such as depression, anxiety, or changes in behavior Fatigue
Exams and Tests
The health care provider will perform a physical exam and ask about your symptoms.
Tests that may be done include:
- 24-hour urine sample to measure cortisol and
- Blood tests to check ACTH,
cortisol, and potassiumlevels Dexamethasone suppression test Fasting glucose MRIand high resolution CT scansto find the tumor
The best treatment for ectopic Cushing syndrome is surgery to remove the tumor. Surgery is usually possible when the tumor is noncancerous (
In some cases, the tumor is cancerous and spreads to other areas of the body before the doctor can discover the problem with cortisol production. Surgery may not be possible in these cases. But the doctor may prescribe medicines to block cortisol production.
Surgery to remove the tumor may lead to full recovery. But there is a chance that the tumor will come back.
The tumor may spread or return after surgery. A high cortisol level may continue.
When to Contact a Medical Professional
Call your health care provider if you develop symptoms of Cushing syndrome.
Prompt treatment of tumors may reduce the risk in some cases. Many cases are not preventable.