Palliative therapy of an ectopic cushing's syndrome due to a metastatic carcinoid tumor

Summary The case of a 39-year-old patient with ectopic Cushing's syndrome due to a metastatic carcinoid tumor is presented. Palliative therapy consisting of 800 mg ketokonazole and 0.3 mg SMS 201-995/die resulted in clinical remission and correction of hypokaelmia and hypercortisoluria. Combined therapy was clearly superior to monotherapy with ketokonazole or SMS 201-995, respectively. Side effects were not observed, the tumor masses remained unchanged throughout the observation period of now 19 months.Abbreviations ACTH adrenocorticotropic hormone - opDDD 1,1 dichloro-2(o-chlorophenyl)-2-(p-chlorophenyl)-ethane - 5-HIAA 5-hydroxyindolaceticacid - VIP vasoactive intestinal pepide - CRH corticotropin releasing hormone