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Cushing's syndrome with a large pituitary adenoma producing both corticotropin-releasing hormone (CRH) and adrenocorticotropin (ACTH)
Authors:Yamada Yuya  Ohashi Akiko  Inoue Toru  Sakaguchi Katsuhiko  Tsujimura Takahiro  Okamoto Daisuke  Itatani Hiroaki  Fujimoto Naomi  Kusaka Kazumasa  Fushimi Hisako
Institution:Department of Internal Medicine, Tokushima Municipal Hospital.
Abstract:A 57-year-old man showed high serum cortisol, plasma adrenocorticotropin (ACTH) and corticotropin-releasing hormone (CRH) levels with a large pituitary tumor and a prostatic cancer. High dose dexamethasone did not suppress cortisol secretion and CRH administration did not stimulate cortisol secretion. After surgical removal of the pituitary tumor, plasma CRH, ACTH and serum cortisol levels were normalized. Histological examinations showed pituitary adenoma and prostatic adenocarcinoma, and pituitary adenoma was stained with both anti-CRH and anti-ACTH antibodies, but prostatic cancer was not stained. A CRH-producing pituitary adenoma is a new type of Cushing's syndrome.
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