Cushing's syndrome caused by Ewing's sarcoma secreting corticotropin releasing factor-like peptide

• Published in: American journal of diseases of children (1960) Vol. 146; no. 9; p. 1103
• Main Authors: Preeyasombat, C, Sirikulchayanonta, V, Mahachokelertwattana, P, Sriphrapradang, A, Boonpucknavig, S
• Format: Journal Article
• Language: English
• Published: United States 01.09.1992
• Subjects: Adrenocorticotropic Hormone - analysis; Amputation; Bone Neoplasms - metabolism; Bone Neoplasms - surgery; Child; Corticotropin-Releasing Hormone - analysis; Corticotropin-Releasing Hormone - metabolism; Cushing Syndrome - etiology; Cushing Syndrome - metabolism; Female; Humans; Immunoenzyme Techniques; Paraneoplastic Endocrine Syndromes - etiology; Paraneoplastic Endocrine Syndromes - metabolism; Sarcoma, Ewing - metabolism; Sarcoma, Ewing - surgery; Tibia - surgery
• ISSN: 0002-922X
• DOI: 10.1001/archpedi.1992.02160210105034

Procedures were carried out in a 12-year-old girl to relate Ewing's sarcoma of the left tibia with Cushing's syndrome. Computed tomography revealed a normal pituitary and hypothalamus but bilateral adrenal hyperplasia without focal enlargement, thus readily excluding hypothalamic-pituitary-adrenal tumor. Negative results from a high-dose dexamethasone suppression test do not support pituitary-dependent Cushing's disease. Ewing's sarcoma was diagnosed on tibial biopsy. The regression of the physical and biochemical findings of Cushing's syndrome subsequent to amputation of the left lower leg strongly suggests ectopic Cushing's syndrome caused by Ewing's sarcoma. Immunohistochemical studies of the resected bone were negative for corticotropin but positive for corticotropin releasing factor-like peptide. We conclude that this is the first reported case of ectopic Cushing's syndrome in a child that is caused by Ewing's sarcoma secreting corticotropin releasing factor-like peptide.