Ectopic Adrenocorticotropic Hormone Syndrome

THE production of hormones and other protein markers by tumors has been an intriguing area of tumor biology. It has become apparent during the last decades that a wide range of endocrine tumors secrete hormones not normally associated with the gland in which the neoplasm arises and that nonendocrine tumors can synthesize and/or secrete polypeptide hormones and other tumor-associated proteins. The production of such tumor markers has come to be referred to as “ectopic” or “inappropriate” when the marker is not obviously associated with the tissue from which the tumor derives. Initially the presence of ectopic hormone secretion caused by cancer was considered as rare or unusual, but with the use of modern techniques of hormone detection these syndromes are felt to be common. Indeed, Odell et al. (1) have postulated that all tumors make POMC and other protein markers.

Meador et al. (2) developed the concept that certain tumors of “nonendocrine” tissues can give rise to Cushing's syndrome by secreting an adrenocorticotropic substance.