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Case Reports: Unusual presentation of more common disease/injury
ACTH-secreting metastatic prostate cancer with neuroendocrine differentiation
  1. Bashar Hassan1,
  2. Yara Yazbeck2,
  3. Vanessa Akiki2,
  4. Ibrahim Salti2 and
  5. Arafat Tfayli3
  1. 1Faculty of Medicine, American University of Beirut, Beirut, Lebanon
  2. 2Division of Endocrinology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
  3. 3Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
  1. Correspondence to Professor Arafat Tfayli; at35{at}aub.edu.lb

Abstract

Cushing’s syndrome (CS) due to ectopic adrenocorticotropic hormone (ACTH) secretion (EAS) can result from a variety of tumours and rarely from those of prostatic origin. We present a male patient in his early 60s with ACTH-secreting metastatic prostate adenocarcinoma with neuroendocrine differentiation (ICD-O code 8574/3) years after prostatectomy and androgen-deprivation therapy, initially presenting with Cushingoid features. After open radical prostatectomy and bilateral orchiectomy for disease recurrence, the patient was found to have metastatic liver and bone lesions highly suggestive of metastatic prostatic cancer. About 10% of cells on liver biopsy expressed ACTH, a finding consistent with EAS as the cause of CS. His stay was complicated with multiple infections and ultimate death. Hence, we report a case of metastatic prostate adenocarcinoma with neuroendocrine differentiation who presented with CS. We also emphasize the importance of adequate and timely treatment.

  • Adrenal disorders
  • Metabolic disorders
  • Endocrine cancer
  • Prostate Cancer

http://dx.doi.org/10.1136/bcr-2021-247997

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    Footnotes

    • Contributors BH drafted the paper. BH, YY, and VA designed the figures and tables. All authors contributed to patient care and editing the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.