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Treatment‐related neuroendocrine prostate cancer resulting in Cushing's syndrome
Author(s) -
Ramalingam Sundhar,
Eisenberg Adva,
Foo Wen Chi,
Freedman Jennifer,
Armstrong Andrew J,
Moss Larry G,
Harrison Michael R
Publication year - 2016
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.13225
Subject(s) - medicine , prostate cancer , hypokalemia , prostate , cushing syndrome , disease , pathology , biopsy , weakness , cancer , oncology , surgery
Here we present, to the best of our knowledge, the first case of a paraneoplastic Cushing's syndrome (hypercortisolism) resulting from treatment‐related neuroendocrine prostate cancer – a highly aggressive and difficult disease to treat. A 51‐year‐old man was started on androgen deprivation therapy after presenting with metastatic prostate cancer, characterized by diffuse osseous metastasis. Shortly thereafter, he developed progressive disease with biopsy proven neuroendocrine prostate cancer as well as symptoms of increased skin pigmentation, hypokalemia, hypertension, hyperglycemia and profound weakness, consistent with ectopic Cushing's syndrome. Molecular analysis of the patient's tumor through RNA sequencing showed high expression of several genes including CHGA , ASCL1 , CALCA , HES6 , PCSK1 , CALCB and INSM1 confirming his neuroendocrine phenotype; elevated POMC expression was found, supporting the diagnosis of ectopic Cushing's syndrome.