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Erschienen in:

16.11.2018 | Originalien

Endokrine paraneoplastische Syndrome

verfasst von: Prof. Dr. N. Reisch, Prof. Dr. M. Reincke

Erschienen in: Journal für Endokrinologie, Diabetologie und Stoffwechsel | Ausgabe 4/2018

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Zusammenfassung

Endokrine paraneoplastische Syndrome sind die Folge der Sekretion bioaktiver Substanzen aus neoplastischen Zellen endokrinen oder neuroendokrinen Ursprungs, die in einer Vielzahl von Organen vorkommen. Typischerweise sind sie in der Lunge, dem Gastrointestinaltrakt, dem Pankreas, der Schilddrüse, dem Nebennierenmark, der Haut, Prostata oder Brust lokalisiert. Charakteristisch für endokrine paraneoplastische Syndrome ist, dass die Sekretion von Peptiden, Aminen oder anderen bioaktiven Substanzen ektop ist und die Symptome nicht durch den physiologischen Ursprung bedingt sind. Die klinische Präsentation aufgrund einer ektopen Hormonsekretion ist jedoch nicht zu unterscheiden von einem zunächst erwarteten eutopen endokrinen Tumor, was eine diagnostische Herausforderung darstellt. Am häufigsten werden Tumoren mit einer Sekretion von antidiuretischem Hormon (Folge: Hyponatriämie), von adrenokortikotropem Hormon bzw. sehr selten Kortikotropin-Releasing-Hormon (Folge: Cushing-Syndrom) oder von Growth-Hormone-Releasing-Hormon (Folge: Akromegalie) beobachtet. Die meisten endokrinen paraneoplastischen Syndrome nichtendokriner Tumoren kommen bei hochmalignen Tumoren vor. Sie korrelieren aber nicht immer mit Tumorstadium, malignem Potenzial oder Prognose. Da die ektope Hormonproduktion eine seltene Komplikation ist, gibt es kaum evidenzbasierte Therapieempfehlungen. Im Vordergrund steht die Therapie der Grunderkrankung, im Falle einer palliativen Therapie kann symptomatisch therapiert werden.
Literatur
2.
Zurück zum Zitat Hansen O, Sorensen P, Hansen KH (2010) The occurrence of hyponatremia in SCLC and the influence on prognosis: a retrospective study of 453 patients treated in a single institution in a 10-year period. Lung Cancer 68:111–114CrossRefPubMed Hansen O, Sorensen P, Hansen KH (2010) The occurrence of hyponatremia in SCLC and the influence on prognosis: a retrospective study of 453 patients treated in a single institution in a 10-year period. Lung Cancer 68:111–114CrossRefPubMed
3.
Zurück zum Zitat Raftopoulos H (2007) Diagnosis and management of hyponatremia in cancer patients. Support Care Cancer 15:1341–1347CrossRefPubMed Raftopoulos H (2007) Diagnosis and management of hyponatremia in cancer patients. Support Care Cancer 15:1341–1347CrossRefPubMed
4.
Zurück zum Zitat Verbalis JG, Goldsmith SR, Greenberg A, Korzelius C, Schrier RW, Sterns RH, Thompson CJ (2013) Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med 126:1–42CrossRef Verbalis JG, Goldsmith SR, Greenberg A, Korzelius C, Schrier RW, Sterns RH, Thompson CJ (2013) Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med 126:1–42CrossRef
5.
Zurück zum Zitat Ellison DH, Berl T (2007) Clinical practice. The syndrome of inappropriate antidiuresis. N Engl J Med 356:2064–2072CrossRefPubMed Ellison DH, Berl T (2007) Clinical practice. The syndrome of inappropriate antidiuresis. N Engl J Med 356:2064–2072CrossRefPubMed
6.
Zurück zum Zitat Corona G, Giuliani C, Parenti G, Norello D, Verbalis JG, Forti G, Maggi M, Peri A (2013) Moderate hyponatremia is associated with increased risk of mortality: evidence from a meta-analysis. PLoS ONE 8:e80451CrossRefPubMedPubMedCentral Corona G, Giuliani C, Parenti G, Norello D, Verbalis JG, Forti G, Maggi M, Peri A (2013) Moderate hyponatremia is associated with increased risk of mortality: evidence from a meta-analysis. PLoS ONE 8:e80451CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Thajudeen B, Salahudeen AK (2016) Role of tolvaptan in the management of hyponatremia in patients with lung and other cancers: current data and future perspectives. Cancer Manag Res 8:105–114CrossRefPubMedPubMedCentral Thajudeen B, Salahudeen AK (2016) Role of tolvaptan in the management of hyponatremia in patients with lung and other cancers: current data and future perspectives. Cancer Manag Res 8:105–114CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Alexandraki KI, Grossman AB (2010) The ectopic ACTH syndrome. Rev Endocr Metab Disord 11:117–126CrossRefPubMed Alexandraki KI, Grossman AB (2010) The ectopic ACTH syndrome. Rev Endocr Metab Disord 11:117–126CrossRefPubMed
9.
Zurück zum Zitat Barbosa SL, Rodien P, Leboulleux S, Niccoli-Sire P, Kraimps JL, Caron P, Archambeaud-Mouveroux F, Conte-Devolx B, Rohmer V, Groupe d’Etude des Tumeurs Endocrines (2005) Ectopic adrenocorticotropic hormone-syndrome in medullary carcinoma of the thyroid: a retrospective analysis and review of the literature. Thyroid 15:618–623CrossRefPubMed Barbosa SL, Rodien P, Leboulleux S, Niccoli-Sire P, Kraimps JL, Caron P, Archambeaud-Mouveroux F, Conte-Devolx B, Rohmer V, Groupe d’Etude des Tumeurs Endocrines (2005) Ectopic adrenocorticotropic hormone-syndrome in medullary carcinoma of the thyroid: a retrospective analysis and review of the literature. Thyroid 15:618–623CrossRefPubMed
10.
Zurück zum Zitat Isidori AM, Kaltsas GA, Pozza C, Frajese V, Newell-Price J, Reznek RH, Jenkins PJ, Monson JP, Grossman AB, Besser GM (2006) The ectopic adrenocorticotropin syndrome: clinical features, diagnosis, management, and long-term follow-up. J Clin Endocrinol Metab 91:371–377CrossRefPubMed Isidori AM, Kaltsas GA, Pozza C, Frajese V, Newell-Price J, Reznek RH, Jenkins PJ, Monson JP, Grossman AB, Besser GM (2006) The ectopic adrenocorticotropin syndrome: clinical features, diagnosis, management, and long-term follow-up. J Clin Endocrinol Metab 91:371–377CrossRefPubMed
11.
Zurück zum Zitat Ilias I, Torpy DJ, Pacak K, Mullen N, Wesley RA, Nieman LK (2005) Cushing’s syndrome due to ectopic corticotropin secretion: twenty years’ experience at the National Institutes of Health. J Clin Endocrinol Metab 90:4955–4962CrossRefPubMed Ilias I, Torpy DJ, Pacak K, Mullen N, Wesley RA, Nieman LK (2005) Cushing’s syndrome due to ectopic corticotropin secretion: twenty years’ experience at the National Institutes of Health. J Clin Endocrinol Metab 90:4955–4962CrossRefPubMed
12.
Zurück zum Zitat Kamp K, Alwani RA, Korpershoek E, Franssen GJ, de Herder WW, Feelders RA (2016) Prevalence and clinical features of the ectopic ACTH syndrome in patients with gastroenteropancreatic and thoracic neuroendocrine tumors. Eur J Endocrinol 174:271–280CrossRefPubMed Kamp K, Alwani RA, Korpershoek E, Franssen GJ, de Herder WW, Feelders RA (2016) Prevalence and clinical features of the ectopic ACTH syndrome in patients with gastroenteropancreatic and thoracic neuroendocrine tumors. Eur J Endocrinol 174:271–280CrossRefPubMed
13.
Zurück zum Zitat Morandi U, Casali C, Rossi G (2006) Bronchial typical carcinoid tumors. Semin Thorac Cardiovasc Surg 18:191–198CrossRefPubMed Morandi U, Casali C, Rossi G (2006) Bronchial typical carcinoid tumors. Semin Thorac Cardiovasc Surg 18:191–198CrossRefPubMed
14.
Zurück zum Zitat Page-Wilson G, Freda PU, Jacobs TP, Khandji AG, Bruce JN, Foo ST, Meece K, White A, Wardlaw SL (2014) Clinical utility of plasma POMC and AgRP measurements in the differential diagnosis of ACTH-dependent Cushing’s syndrome. J Clin Endocrinol Metab 99:E1838–45CrossRefPubMedPubMedCentral Page-Wilson G, Freda PU, Jacobs TP, Khandji AG, Bruce JN, Foo ST, Meece K, White A, Wardlaw SL (2014) Clinical utility of plasma POMC and AgRP measurements in the differential diagnosis of ACTH-dependent Cushing’s syndrome. J Clin Endocrinol Metab 99:E1838–45CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Nimalasena S, Freeman A, Harland S (2008) Paraneoplastic Cushing’s syndrome in prostate cancer: a difficult management problem. BJU Int 101:424–427CrossRefPubMed Nimalasena S, Freeman A, Harland S (2008) Paraneoplastic Cushing’s syndrome in prostate cancer: a difficult management problem. BJU Int 101:424–427CrossRefPubMed
16.
Zurück zum Zitat Nagy-Mignotte H, Shestaeva O, Vignoud L, Guillem P, Ruckly S, Chabre O, Sakhri L, Duruisseaux M, Mousseau M, Timsit JF, Moro-Sibilot D, Multidisciplinary Thoracic Oncology Group at Grenoble University Hospital, France (2014) Prognostic impact of paraneoplastic cushing’s syndrome in small-cell lung cancer. J Thorac Oncol 9:497–505CrossRefPubMed Nagy-Mignotte H, Shestaeva O, Vignoud L, Guillem P, Ruckly S, Chabre O, Sakhri L, Duruisseaux M, Mousseau M, Timsit JF, Moro-Sibilot D, Multidisciplinary Thoracic Oncology Group at Grenoble University Hospital, France (2014) Prognostic impact of paraneoplastic cushing’s syndrome in small-cell lung cancer. J Thorac Oncol 9:497–505CrossRefPubMed
17.
Zurück zum Zitat Li WY, Liu XD, Li WN, Dong SY, Qu XH, Gong SL, Shao MR, Zhang L (2016) Paraneoplastic Cushing’s syndrome associated with bronchopulmonary carcinoid tumor in youth: a case report and review of the literature. Oncol Lett 12:69–72CrossRefPubMedPubMedCentral Li WY, Liu XD, Li WN, Dong SY, Qu XH, Gong SL, Shao MR, Zhang L (2016) Paraneoplastic Cushing’s syndrome associated with bronchopulmonary carcinoid tumor in youth: a case report and review of the literature. Oncol Lett 12:69–72CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Zemskova MS, Nylen ES, Patronas NJ, Oldfield EH, Becker KL, Nieman LK (2009) Diagnostic accuracy of chromogranin A and calcitonin precursors measurements for the discrimination of ectopic ACTH secretion from Cushing’s disease. J Clin Endocrinol Metab 94:2962–2965CrossRefPubMedPubMedCentral Zemskova MS, Nylen ES, Patronas NJ, Oldfield EH, Becker KL, Nieman LK (2009) Diagnostic accuracy of chromogranin A and calcitonin precursors measurements for the discrimination of ectopic ACTH secretion from Cushing’s disease. J Clin Endocrinol Metab 94:2962–2965CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Jia R, Sulentic P, Xu JM, Grossman AB (2017) Thymic neuroendocrine neoplasms: biological behaviour and therapy. Neuroendocrinology 105:105–114CrossRefPubMed Jia R, Sulentic P, Xu JM, Grossman AB (2017) Thymic neuroendocrine neoplasms: biological behaviour and therapy. Neuroendocrinology 105:105–114CrossRefPubMed
20.
Zurück zum Zitat Neary NM, Lopez-Chavez A, Abel BS, Boyce AM, Schaub N, Kwong K, Stratakis CA, Moran CA, Giaccone G, Nieman LK (2012) Neuroendocrine ACTH-producing tumor of the thymus – experience with 12 patients over 25 years. J Clin Endocrinol Metab 97:2223–2230CrossRefPubMedPubMedCentral Neary NM, Lopez-Chavez A, Abel BS, Boyce AM, Schaub N, Kwong K, Stratakis CA, Moran CA, Giaccone G, Nieman LK (2012) Neuroendocrine ACTH-producing tumor of the thymus – experience with 12 patients over 25 years. J Clin Endocrinol Metab 97:2223–2230CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Lindsay JR, Nieman LK (2005) Differential diagnosis and imaging in Cushing’s syndrome. Endocrinol Metab Clin North Am 34:403–421, xCrossRefPubMed Lindsay JR, Nieman LK (2005) Differential diagnosis and imaging in Cushing’s syndrome. Endocrinol Metab Clin North Am 34:403–421, xCrossRefPubMed
22.
Zurück zum Zitat Doppman JL, Chang R, Oldfield EH, Chrousos G, Stratakis CA, Nieman LK (1999) The hypoplastic inferior petrosal sinus: a potential source of false-negative results in petrosal sampling for Cushing’s disease. J Clin Endocrinol Metab 84:533–540PubMed Doppman JL, Chang R, Oldfield EH, Chrousos G, Stratakis CA, Nieman LK (1999) The hypoplastic inferior petrosal sinus: a potential source of false-negative results in petrosal sampling for Cushing’s disease. J Clin Endocrinol Metab 84:533–540PubMed
23.
Zurück zum Zitat Colao A, Faggiano A, Pivonello R, Pecori Giraldi F, Cavagnini F, Lombardi G and Study Group of the Italian Endocrinology Society on the Pathophsiology of the Hypothalamic-Pituitary-Adrenal A (2001) Inferior petrosal sinus sampling in the differential diagnosis of Cushing’s syndrome: results of an Italian multicenter study. Eur J Endocrinol 144:499–507CrossRefPubMed Colao A, Faggiano A, Pivonello R, Pecori Giraldi F, Cavagnini F, Lombardi G and Study Group of the Italian Endocrinology Society on the Pathophsiology of the Hypothalamic-Pituitary-Adrenal A (2001) Inferior petrosal sinus sampling in the differential diagnosis of Cushing’s syndrome: results of an Italian multicenter study. Eur J Endocrinol 144:499–507CrossRefPubMed
24.
Zurück zum Zitat Swearingen B, Katznelson L, Miller K, Grinspoon S, Waltman A, Dorer DJ, Klibanski A, Biller BM (2004) Diagnostic errors after inferior petrosal sinus sampling. J Clin Endocrinol Metab 89:3752–3763CrossRefPubMed Swearingen B, Katznelson L, Miller K, Grinspoon S, Waltman A, Dorer DJ, Klibanski A, Biller BM (2004) Diagnostic errors after inferior petrosal sinus sampling. J Clin Endocrinol Metab 89:3752–3763CrossRefPubMed
26.
Zurück zum Zitat Butler PW, Cochran CS, Merino MJ, Nguyen DM, Schrump DS, Gorden P (2012) Ectopic growth hormone-releasing hormone secretion by a bronchial carcinoid tumor: clinical experience following tumor resection and long-acting octreotide therapy. Pituitary 15:260–265CrossRefPubMedPubMedCentral Butler PW, Cochran CS, Merino MJ, Nguyen DM, Schrump DS, Gorden P (2012) Ectopic growth hormone-releasing hormone secretion by a bronchial carcinoid tumor: clinical experience following tumor resection and long-acting octreotide therapy. Pituitary 15:260–265CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Garby L, Caron P, Claustrat F, Chanson P, Tabarin A, Rohmer V, Arnault G, Bonnet F, Chabre O, Christin-Maitre S, du-Boullay H, Murat A, Nakib I, Sadoul JL, Sassolas G, Claustrat B, Raverot G, Group (2012) Clinical characteristics and outcome of acromegaly induced by ectopic secretion of growth hormone-releasing hormone (GHRH): a French nationwide series of 21 cases. J Clin Endocrinol Metab 97:2093–2104CrossRefPubMed Garby L, Caron P, Claustrat F, Chanson P, Tabarin A, Rohmer V, Arnault G, Bonnet F, Chabre O, Christin-Maitre S, du-Boullay H, Murat A, Nakib I, Sadoul JL, Sassolas G, Claustrat B, Raverot G, Group (2012) Clinical characteristics and outcome of acromegaly induced by ectopic secretion of growth hormone-releasing hormone (GHRH): a French nationwide series of 21 cases. J Clin Endocrinol Metab 97:2093–2104CrossRefPubMed
28.
Zurück zum Zitat Borson-Chazot F, Garby L, Raverot G, Claustrat F, Raverot V, Sassolas G, GTE group (2012) Acromegaly induced by ectopic secretion of GHRH: a review 30 years after GHRH discovery. Ann Endocrinol (Paris) 73:497–502CrossRef Borson-Chazot F, Garby L, Raverot G, Claustrat F, Raverot V, Sassolas G, GTE group (2012) Acromegaly induced by ectopic secretion of GHRH: a review 30 years after GHRH discovery. Ann Endocrinol (Paris) 73:497–502CrossRef
29.
Zurück zum Zitat Fenske W (2017) Hyponatremia in emergency admissions – often dangerous. Internist (Berl) 58(10):1042–1052CrossRef Fenske W (2017) Hyponatremia in emergency admissions – often dangerous. Internist (Berl) 58(10):1042–1052CrossRef
Metadaten
Titel
Endokrine paraneoplastische Syndrome
verfasst von
Prof. Dr. N. Reisch
Prof. Dr. M. Reincke
Publikationsdatum
16.11.2018
Verlag
Springer Vienna
Erschienen in
Journal für Endokrinologie, Diabetologie und Stoffwechsel / Ausgabe 4/2018
Print ISSN: 3004-8915
Elektronische ISSN: 3004-8923
DOI
https://doi.org/10.1007/s41969-018-0049-0

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