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Petrosal sinus sampling

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https://read.qxmd.com/read/32102127/adrenocorticotropic-hormone-secreting-esthesioneuroblastoma-with-ectopic-cushing-s-syndrome
#1
Young Soo Chung, Minkyun Na, Cheol Ryong Ku, Se Hoon Kim, Eui Hyun Kim
Esthesioneuroblastoma as a source of ectopic Cushing's syndrome is rare, and to the best of our knowledge, only 20 cases have been reported worldwide. A 46-year-old healthy man visited a local clinic for general weakness and hyposmia, and underwent examination with serial endocrinological workup and brain imaging. 68 Gallium-DOTA-TOC positron emission tomography scan was helpful where diagnosis of sellar MRI and inferior petrosal sinus sampling were discordant. Combined transcranial and endoscopic endonasal approach surgery was performed, and a diagnosis of esthesioneuroblastoma was given...
March 2020: Yonsei Medical Journal
https://read.qxmd.com/read/31998497/ectopic-cushing-s-syndrome-in-a-patient-with-inferior-petrosal-sinus-sampling-indicating-pituitary-dependent-acth-secretion
#2
Alexander Micko, Stefan Wolfsberger, Engelbert Knosp, Wolfgang Marik, Christine Haberler, Yvonne Winhofer, Anton Luger, Greisa Vila
In an unclear case of Cushing's syndrome, IPSS identifies the origin of ACTH secretion, and together with MRI enables the localization of an ectopic corticotroph adenoma in the parasellar or cavernous sinuses region.
January 2020: Clinical Case Reports
https://read.qxmd.com/read/31967055/cushing-disease-masquerading-as-glaucoma
#3
Yumiko Tsushima, Lubna Bashir Munshi, Charit Taneja, Se-Min Kim
Objective: Glaucoma is a well-recognized side effect of corticosteroids. However, steroid-induced glaucoma typically refers to that caused by exogenous corticosteroid administration. Glaucoma secondary to endogenous overproduction of corticosteroids has only been reported in a few case reports. We aim to bring attention to glaucoma as a rare but important manifestation of endogenous hypercortisolism. Methods: Patient history, physical exam, laboratory results, and imaging studies were reviewed...
September 2019: AACE Clinical Case Reports
https://read.qxmd.com/read/31952032/external-jugular-venous-sampling-for-cushing-s-disease-in-a-patient-with-hypoplastic-inferior-petrosal-sinuses
#4
Keyan A Peterson, Christofer D Burnette, Kyle M Fargen, Patrick A Brown, James L West, Stephen B Tatter, Stacey Q Wolfe
The authors report the case of a 30-year-old female patient with suspected Cushing's disease with an anatomical variation of hypoplastic inferior petrosal sinuses and nearly exclusive anterior drainage from the cavernous sinus, who underwent external jugular venous blood sampling with successful disease confirmation and microadenoma localization. The patient presented with signs and symptoms consistent with Cushing's syndrome, but with discordant preliminary diagnostic testing. She underwent attempted bilateral inferior petrosal sinus sampling; however, she had hypoplastic inferior petrosal sinuses bilaterally and predominantly anterior drainage from the cavernous sinus into the external jugular circulation...
January 17, 2020: Journal of Neurosurgery
https://read.qxmd.com/read/31787931/toward-a-diagnostic-score-in-cushing-s-syndrome
#5
REVIEW
Leah T Braun, Anna Riester, Andrea Oßwald-Kopp, Julia Fazel, German Rubinstein, Martin Bidlingmaier, Felix Beuschlein, Martin Reincke
Cushing's syndrome (CS) is a classical rare disease: it is often suspected in patients who do not have the disease; at the same time, it takes a mean of 3 years to diagnose CS in affected individuals. The main reason is the extreme rarity (1-3/million/year) in combination with the lack of a single lead symptom. CS has to be suspected when a combination of signs and symptoms is present, which together make up the characteristic phenotype of cortisol excess. Unusual fat distribution affecting the face, neck, and trunk; skin changes including plethora, acne, hirsutism, livid striae, and easy bruising; and signs of protein catabolism such as thinned and vulnerable skin, osteoporotic fractures, and proximal myopathy indicate the need for biochemical screening for CS...
2019: Frontiers in Endocrinology
https://read.qxmd.com/read/31777545/endoscopic-surgical-treatment-of-cushing-s-disease-a-single-center-experience-of-cauterization-of-peritumoral-tissues
#6
Songyu Chen, Shujun Xu, Fuxin Lin, Xin Zhang, Fuqiang Liu, Ming Dong, Xingang Li, Xiangyu Ma
Endoscopic transsphenoidal surgery is a form of treatment for Cushing's disease that is initially preferred compared with other types of treatment. Peritumoral tissue is inactivated by cauterization if a clear border of the lesion cannot be identified. In order to compare the surgical outcomes and post-operative complications between patients who underwent inactivation (cauterization of peritumoral tissues is referred to as inactivation) and those who did not, the medical records of patients treated between January 2010 and June 2016 were retrospectively reviewed...
December 2019: Experimental and Therapeutic Medicine
https://read.qxmd.com/read/31758170/the-optimal-cutoff-of-bipss-in-differential-diagnosis-of-acth-dependent-cushing-s-syndrome-is-stimulation-necessary
#7
Shi Chen, Kang Chen, Shirui Wang, Huijuan Zhu, Lin Lu, Xiaobo Zhang, Anli Tong, Hui Pan, Renzhi Wang, Zhaolin Lu
CONTEXTS: Bilateral inferior petrosal sinus sampling (BIPSS) can differentiate Cushing's disease (CD) and ectopic ACTH syndrome (EAS). The traditional cutoff of inferior petrosal sinus to peripheral (IPS:P) ACTH gradient was 2 before stimulation and 3 after stimulation, which yielded unsatisfactory sensitivity in some studies. OBJECTIVES: To determine the optimal cutoff in BIPSS before or after desmopressin stimulation, and to evaluate the necessity of stimulation...
November 23, 2019: Journal of Clinical Endocrinology and Metabolism
https://read.qxmd.com/read/31640675/a-pitfall-of-bilateral-inferior-petrosal-sinus-sampling-in-cyclic-cushing-s-syndrome
#8
Adriana Albani, Christina M Berr, Felix Beuschlein, Marcus Treitl, Klaus Hallfeldt, Jürgen Honegger, Günter Schnauder, Martin Reincke
BACKGROUND: Clinical care of patients with cyclic Cushing's syndrome (CS) is challenging. Classical pitfalls include incorrect subtyping, unnecessary surgical procedures and delayed definite treatment. CASE PRESENTATION: A 43-year-old female suffered from a rapidly cycling ectopic CS. She experienced six cycles of severe hypercortisolism within a 2 year period (maximum plasma cortisol 5316 nmol/L, normal range 124.2-662.4 nmol/L; maximum urinary free cortisol 79,469 nmol/24 h, normal range < 414 nmol/24 h) lasting 2-9 weeks...
October 22, 2019: BMC Endocrine Disorders
https://read.qxmd.com/read/31631643/pulmonary-nocardiosis-associated-with-cushing-s-disease-a-case-report
#9
Charalampos C Mylonas, Georgia Gomatou, Athina Asimakopoulou, Christos Masaoutis, George Kyriakopoulos, Maria Kopelia, Konstantinos Syrigos, Garyphallia Poulakou
Nocardia spp. is a genus of Gram-positive bacteria which can cause cutaneous, pleuropulmonary, or disseminated disease. The latter two forms are encountered in immunocompromised patients, with prolonged usage of corticosteroids being a well-recognized risk factor. However, endogenous Cushing's syndrome is less frequently associated with nocardiosis. We report on a 40-year-old woman who presented for further workup of abnormal findings in the chest computed tomography (three lung nodules, one of which being cavitary)...
October 18, 2019: Monaldi Archives for Chest Disease
https://read.qxmd.com/read/31627184/olfactory-neuroblastoma-esthesioneuroblastoma-presenting-as-ectopic-acth-syndrome-always-follow-your-nose
#10
Karen Decaestecker, Veerle Wijtvliet, Peter Coremans, Nike Van Doninck
Summary: ACTH-dependent hypercortisolism is caused by an ectopic ACTH syndrome (EAS) in 20% of cases. We report a rare cause of EAS in a 41-year-old woman, presenting with clinical features of Cushing's syndrome which developed over several months. Biochemical tests revealed hypokalemic metabolic alkalosis and high morning cortisol and ACTH levels. Further testing, including 24-hour urine analysis, late-night saliva and low-dose dexamethasone suppression test, confirmed hypercortisolism...
October 17, 2019: Endocrinology, Diabetes & Metabolism Case Reports
https://read.qxmd.com/read/31412094/petrosal-morphology-and-cochlear-function-in-mesozoic-stem-therians
#11
Tony Harper, Guillermo W Rougier
Here we describe the bony anatomy of the inner ear and surrounding structures seen in three plesiomorphic crown mammalian petrosal specimens. Our study sample includes the triconodont Priacodon fruitaensis from the Upper Jurassic of North America, and two isolated stem therian petrosal specimens colloquially known as the Höövör petrosals, recovered from Aptian-Albian sediments in Mongolia. The second Höövör petrosal is here described at length for the first time. All three of these petrosals and a comparative sample of extant mammalian taxa have been imaged using micro-CT, allowing for detailed anatomical descriptions of the osteological correlates of functionally significant neurovascular features, especially along the abneural wall of the cochlear canal...
2019: PloS One
https://read.qxmd.com/read/31352698/pulmonary-embolism-as-the-presenting-symptom-and-a-confounder-in-acth-secreting-bronchial-carcinoid
#12
Wei Yang, David Pham, Aren Vierra, Sarah Azam, Dorina Gui, John Yoon
Summary: Ectopic ACTH-secreting pulmonary neuroendocrine tumors are rare and account for less than 5% of endogenous Cushing’s syndrome cases. We describe an unusual case of metastatic bronchial carcinoid tumor in a young woman presenting with unprovoked pulmonary emboli, which initially prevented the detection of the primary tumor on imaging. The source of ectopic ACTH was ultimately localized by a Gallium-DOTATATE scan, which demonstrated increased tracer uptake in a right middle lobe lung nodule and multiple liver nodules...
July 26, 2019: Endocrinology, Diabetes & Metabolism Case Reports
https://read.qxmd.com/read/31251726/diagnosis-of-cyclic-cushing-s-disease-manifests-as-early-morning-hyperglycemia-in-a-patient-with-previously-well-controlled-type-1-diabetes
#13
Carol Singer-Granick, James K Liu, David Bleich, Lissette Cespedes
Background Cyclic Cushing's disease (CCD) is reported to occur in approximately 15% of patients with Cushing's disease (CD). CCD is a rare phenomenon in children. Case presentation A Portuguese female with well-controlled type 1 diabetes (T1DM) on an insulin pump developed transient uncontrolled blood sugar every morning. Increased basal and bolus insulin dosing was ineffective in lowering blood sugar and she began to miss school because of nausea, vomiting, fatigue, but no ketoacidosis. Therefore, other causes of sporadic hyperglycemia were explored...
June 28, 2019: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://read.qxmd.com/read/31228539/influence-of-inferior-petrosal-sinus-drainage-symmetry-on-detection-of-adenomas-in-cushing-s-syndrome
#14
Lukas Andereggen, Jan Gralla, Gerhard Schroth, Pasquale Mordasini, Robert H Andres, Hans Rudolf Widmer, Markus M Luedi, Frauke Kellner, Jürgen Beck, Luigi Mariani, Christoph Ozdoba, Emanuel Christ
BACKGROUND: Asymmetric inferior petrosal sinuses (IPS) are not infrequently encountered during bilateral IPS sampling. There is little data on whether IPS symmetry influences success in predicting the adenoma side in patients with ACTH-dependent Cushing's syndrome (CS). OBJECTIVE: To assess the influence of IPS drainage patterns on detection of an adenoma in CS. METHODS: Retrospective single-center cohort analysis reviewing records of patients with CS and negative MRI findings who subsequently underwent BIPSS...
June 19, 2019: Journal of Neuroradiology. Journal de Neuroradiologie
https://read.qxmd.com/read/31201401/challenges-in-diagnosis-of-disease-reported-100-years-back-cushing-syndrome-recent-advances
#15
Muhammad Azeemuddin, Shahmeer Khan, Ayesha Shoukat Hussain, Asma Ahmed, Raza Sayani, Shaheer Khan
Treatment of Cushing syndrome depends on diagnosis of etiology responsible for hypercortisolism in the body, which sometimes presents with a challenge. Inferior petrosal sinus sampling for ACTH levels, followed by peripheral venous sampling is a proven tool to be a gold standard for differentiating between peripheral and central cause of ACTH dependent Cushing syndrome. This case report is of an elderly female who presented as an outpatient in the endocrinology clinic of Aga Khan university hospital on 22/6/2017 with clinical features of hypercortisolism...
June 2019: JPMA. the Journal of the Pakistan Medical Association
https://read.qxmd.com/read/31180388/ectopic-cushing-s-syndrome-due-to-adrenocorticotropic-hormone-secreting-atypical-thymic-carcinoid-tumor
#16
Cevdet Duran, Meryem Ilkay Eren Karanis, Suleyman Bakdik, Uysaler Aslan, Mustafa Calik, Saniye Goknil Calik
Cushing's syndromes (CS) due to thymic carcinoids are rarely seen. In this text, a case with CS due to ectopic adrenocorticotropic hormone (ACTH) secreting atypical thymic carcinoid tumor is presented. A 50-year-old Turkish male patient was admitted to our emergency department with typical CS features. Basal hormone profile, low- and high-dose dexamethasone suppression tests, and inferior petrosal sinus sampling results were consistent with ectopic ACTH secretion. Thorax computerized tomography showed an upper mediastinal mass, and trans-thoracic biopsy showed atypical thymic carcinoid with positive ACTH staining...
2019: Northern Clinics of Istanbul
https://read.qxmd.com/read/31180374/efficiency-of-inferior-petrosal-sinus-sampling-in-the-diagnosis-of-cushing-s-disease-and-comparison-with-magnetic-resonance-imaging
#17
Tumay Bekci, Umit Belet, Aysegul Idil Soylu, Fatih Uzunkaya, Mesut Ozturk, Aysegul Atmaca
OBJECTIVE: The purpose of this study is to assess the efficiency of inferior petrosal sinus sampling (IPSS) in the diagnosis of adrenocorticotropic hormone-dependent Cushing's disease and to compare it with magnetic resonance imaging (MRI). METHODS: The diagnostic efficiency of IPSS in the differentiation of pituitary Cushing's disease from ectopic Cushing's disease was retrospectively evaluated in 37 patients who had IPSS in our clinic. Six patients were excluded from the study due to missing data...
2019: Northern Clinics of Istanbul
https://read.qxmd.com/read/31137142/-surgical-treatment-for-cushing-s-disease-with-negative-results-in-high-dose-dexamethasone-suppression-tests
#18
H Y Ni, K J Qin, Q F Sun, L G Bian
Objective: To analyze the indication and the outcome of trans-sphenoidal surgery (TSS) in Cushing's disease (CD) with negative high dose dexamethasone suppression tests (HDDST) results. Methods: Eighteen cases of ACTH-dependent Cushing's syndrome (CS) with negative HDDST results in the Department of Neurosurgery in Shanghai Ruijin Hospital from January 2015 to December 2017 were retrospectively reviewed. All patients underwent TSS. There were 5 males and 13 females, with an average age of (41±14) years. Results: All patients underwent bilateral inferior petrosal sinus sampling (BIPSS) before the surgery and got evidence of pituitary origin of ACTH secretion...
May 21, 2019: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://read.qxmd.com/read/31061299/-subacute-myopathy-in-a-patient-with-mild-cushing-disease-manifested-by-accompanying-kleinfelter-syndrome
#19
Yoshiki Shimizu, Akihiro Kitamura, Tsuyoshi Tsukamoto, Hyoh Kim, Hiromichi Kawai, Makoto Urushitani
A 69-year-old man was admitted because of subacute development of lower limb weakness from one month ago. He showed central obesity, gynecomastia, dorsal fat pad ("buffalo hump"), and proximal muscle weakness in the lower extremities (manual muscle test 4). Needle EMG, muscle MRI and labolatry screening including CPK were negative for neuromuscular diseases, except for the hypogenitalism accidentally detected in MRI. Although blood corticol was in normal range, the levels of serum ACTH and 24-hour urinary free cortisol excretion were high, and the dexamethasone suppression tests were positive...
April 26, 2019: Rinshō Shinkeigaku, Clinical Neurology
https://read.qxmd.com/read/31016154/prolactin-adjusted-acth-ratio-in-predicting-lateralization-of-acth-source-during-simultaneous-bilateral-inferior-petrosal-sinus-sampling-in-patients-with-cushing-s-disease
#20
Kush Dev Singh Jarial, Anil Bhansali, Kanchan K Mukherjee, Rimesh Pal, Vivek Gupta, Akhilesh Sharma, Rakesh K Vasishta, Suja P Sukumar, Naresh Sachdeva, Rama Walia
Introduction: Prolactin-adjusted adrenocorticotropic hormone (ACTH) ratio is used to improve the diagnostic accuracy of bilateral inferior petrosal sinus sampling (BIPSS) for lateralization of pituitary adenoma. Objective: To study the use of prolactin for successful catheterization during BIPSS, the role of prolactin-normalized ACTH ratio for confirmation of Cushing's disease (CD) and prolactin-adjusted ACTH ratio in predicting the lateralization. Patients and Methods: BIPSS was done in patients with CD; prolactin-adjusted ACTH ratio was compared with intersinus ACTH ratio, magnetic resonance imaging, and intraoperative findings for localization of pituitary adenoma...
January 2019: Indian Journal of Endocrinology and Metabolism
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