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Titolo:
Ectopic ACTH syndrome: Molecular bases and clinical heterogeneity
Autore:
Terzolo, M; Reimondo, G; Ali, A; Bovio, S; Daffara, F; Paccotti, P; Angeli, A;
Indirizzi:
Univ Turin, ASO San Luigi, Med Clin, Dipartimento Sci Clin & Biol, I-10043Orbassano, TO, Italy Univ Turin Orbassano TO Italy I-10043 & Biol, I-10043Orbassano, TO, Italy
Titolo Testata:
ANNALS OF ONCOLOGY
, volume: 12, anno: 2001, supplemento:, 2
pagine: S83 - S87
SICI:
0923-7534(2001)12:<S83:EASMBA>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORTICOTROPIN-RELEASING HORMONE; CELL LUNG-CANCER; PARANEOPLASTIC CUSHINGS-SYNDROME; VASOPRESSIN RECEPTOR; PROOPIOMELANOCORTIN; PEPTIDES; EXPRESSION; TUMORS;
Keywords:
ACTH; carcinoid; cortisol; Cushing's syndrome; ectopic secretion; small-cell lung cancer;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Terzolo, M Univ Turin, ASO San Luigi, Med Clin, Dipartimento Sci Clin & Biol, Reg Gonzole 10, I-10043 Orbassano, TO, Italy Univ Turin Reg Gonzole 10 Orbassano TO Italy I-10043 TO, Italy
Citazione:
M. Terzolo et al., "Ectopic ACTH syndrome: Molecular bases and clinical heterogeneity", ANN ONCOL, 12, 2001, pp. S83-S87

Abstract

There are roughly two types of ectopic ACTH syndrome (EAS), one associatedwith overt malignancies and one with occult neoplasms. The prototype of the first condition is Cushing's syndrome sustained by small-cell lung cancer(SCLC), while bronchial carcinoid tumors are the most common occult sources of ACTH. Patients with EAS and SCLC may have an atypical presentation with muscle wasting and weight loss that are more frequently observed than theclassic cushingoid features. These patients have a poor prognosis because SCLC associated with the EAS is more resistant to chemotherapy and the severe hypercortisolism is responsible for a high rate of life-threatening complications during treatment. Conversely, the clinical and biochemical features of the EAS associated with carcinoid may overlap those seen in pituitary-dependent Cushing's syndrome. An extensive radiological and hormonal work-up is necessary to detect the extrapituitary source of ACTH. However, the differentiation between the pituitary, or eutopic, from the non-pituitary, or ectopic, source of ACTH secretion may be extremely difficult in some cases despite the wide diagnostic armamentarium available. Molecular biology studies have demonstrated that the carcinoid cells achieve a process of corticotroph differentiation being able to express the proopiomelanocortin (POMC) gene and to process POMC correctly to release large amounts of intact ACTH. Conversely, SCLC processes POMC in an aberrant way releasing high concentrations of ACTH precursors and less intact ACTH in the circulation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/04/20 alle ore 04:20:53