Elevated Plasma Level of Lipotropin Revealing an Occult Carcinoid Tumor with Normal Plasma Adrenocorticotropin

• Published in: The journal of clinical endocrinology and metabolism Vol. 86; no. 7; pp. 2997 - 3000
• Main Authors: Coffin, C., Lireux, B., Le Rochais, J. P., Raux-Demay, M. C., Girard, F., Galateau, F., Reznik, Y., Mahoudeau, J.
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Endocrine Society 01.07.2001
• Subjects: Adrenocorticotropic Hormone - blood; Adult; beta-Lipotropin - blood; Biological and medical sciences; Carcinoid Tumor - blood; Carcinoid Tumor - diagnosis; Carcinoid Tumor - pathology; Chromatography, High Pressure Liquid; Corticotropin-Like Intermediate Lobe Peptide; Corticotropin-Releasing Hormone; Endocrinopathies; Female; General aspects. Associated endocrine diseases. Endocrine paraneoplasic syndromes; Humans; Hydrocortisone - blood; Hydrocortisone - urine; Lung Neoplasms - blood; Lung Neoplasms - diagnosis; Lung Neoplasms - pathology; Medical sciences; Peptide Fragments - blood; Pneumology; Tomography, X-Ray Computed; Tumors of the respiratory system and mediastinum; Endocrinopathy; Human; Lung disease; Relapse; Adrenal cortex diseases; Respiratory disease; Lung; Cushing syndrome; Hyperadrenocorticism; Ectopic secretion; Carcinoid tumor; Blood plasma; Case study; Lipotropin hormone; Pituitary hormone; Adrenocorticotropic hormone; Adenohypophyseal hormone; Adrenal gland diseases; Tumor; Adult; Female; Diagnosis; Hormonal investigation
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jcem.86.7.7681

The increases in the level of plasma lipotropin (LPH) and in the LPH/ACTH ratio are considered diagnostic tools in ectopic ACTH syndrome. However, plasma ACTH is also elevated in this syndrome. We report a case of a small carcinoid tumor with an increase in both ACTH and LPH in plasma before surgery. Eight months after the tumoral resection, plasma LPH alone was increased again, whereas plasma ACTH and plasma and urinary cortisol remained normal in this apparently cured patient. This repeated abnormality was the only available feature that allowed successful removal of the occult tumoral residue.