Ectopic ACTH- and/or CRH-Producing Pheochromocytomas

Patrick F. Elliott, Thomas Berhane, Oskar Ragnarsson, Henrik Falhammar

Research output: Contribution to journalArticlepeer-review

Abstract

Context

The characteristics of catecholamine-secreting pheochromocytomas have been well studied. However, less is known about the characteristics, management and outcome in patients with ectopic adrenocorticotropic hormone (ACTH) and/or corticotrophin-releasing hormone (CRH)-secreting pheochromocytomas.

Objective

To review the characteristics and outcomes of ACTH- and/or CRH-secreting pheochromocytomas. 

Data source

A systematic search of PubMed/MEDLINE and Web of Science, identifying relevant reports published up to 10 February 2020. 

Study selection

Original articles, including case reports and case series, reporting individual patient data from patients with ACTH- and/or CRH-secreting pheochromocytomas. 

Data extraction

Information on sex, age, symptoms at presentation, comorbidities, biochemistry, imaging, histopathology, and outcomes was extracted. 

Data synthesis

We identified 91 articles reporting on 99 cases of ACTH- and/or CRH-secreting pheochromocytomas (CRH-secreting n = 4). Median age at diagnosis was 49 years (interquartile range 38-59.5) with a 2:1 female to male ratio. Most patients presented with clinical Cushing syndrome (n = 79; 81%), hypertension (n = 87; 93%), and/or diabetes (n = 50; 54%). Blood pressure, glucose control, and biochemical parameters improved in the vast majority of patients postoperatively. Infections were the most common complication. Most cases (n = 70, 88%) with reported long-term outcome survived to publication (median follow-up 6 months). 

Conclusion

Ectopic ACTH- and/or CRH-secreting pheochromocytoma should be considered in patients presenting with ACTH-dependent Cushing syndrome and adrenal mass. Despite the challenge in diagnosis, patient outcomes appear favorable.

Original languageEnglish
Pages (from-to)598-608
Number of pages11
JournalThe Journal of clinical endocrinology and metabolism
Volume106
Issue number2
DOIs
Publication statusPublished - Feb 2021

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