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Management Strategies for Aggressive Cushing's Syndrome : From Macroadenomas to Ectopics
Joint Authors
Graziadio, Chiara
Pozza, Carlotta
Giannetta, Elisa
Lenzi, Andrea
Isidori, Andrea Maria
Source
Issue
Vol. 2012, Issue 2012 (31 Dec. 2012), pp.1-9, 9 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2012-08-09
Country of Publication
Egypt
No. of Pages
9
Main Subjects
Abstract EN
Cushing’s syndrome (CS) is a rare but severe clinical condition represented by an excessive endogenous cortisol secretion and hence excess circulating free cortisol, characterized by loss of the normal feedback regulation and circadian rhythm of the hypothalamic-pituitary axis due to inappropriate secretion of ACTH from a pituitary tumor (Cushing’s disease, CD) or an ectopic source (ectopic ACTH secretion, EAS).
The remaining causes (20%) are ACTH independent.
As soon as the diagnosis is established, the therapeutic goal is the removal of the tumor.
Whenever surgery is not curative, management of patients with CS requires a major effort to control hypercortisolemia and associated symptoms.
A multidisciplinary approach that includes endocrinologists, neurosurgeons, oncologists, and radiotherapists should be adopted.
This paper will focus on traditional and novel medical therapy for aggressive ACTH-dependent CS.
Several drugs are able to reduce cortisol levels.
Their mechanism of action involves blocking adrenal steroidogenesis (ketoconazole, metyrapone, aminoglutethimide, mitotane, etomidate) or inhibiting the peripheral action of cortisol through blocking its receptors (mifepristone “RU-486”).
Other drugs include centrally acting agents (dopamine agonists, somatostatin receptor agonists, retinoic acid, peroxisome proliferator-activated receptor γ “PPAR-γ” ligands) and novel chemotherapeutic agents (temozolomide and tyrosine kinase inhibitors) which have a significant activity against aggressive pituitary or ectopic tumors.
American Psychological Association (APA)
Pozza, Carlotta& Graziadio, Chiara& Giannetta, Elisa& Lenzi, Andrea& Isidori, Andrea Maria. 2012. Management Strategies for Aggressive Cushing's Syndrome : From Macroadenomas to Ectopics. Journal of Oncology،Vol. 2012, no. 2012, pp.1-9.
https://search.emarefa.net/detail/BIM-490432
Modern Language Association (MLA)
Pozza, Carlotta…[et al.]. Management Strategies for Aggressive Cushing's Syndrome : From Macroadenomas to Ectopics. Journal of Oncology No. 2012 (2012), pp.1-9.
https://search.emarefa.net/detail/BIM-490432
American Medical Association (AMA)
Pozza, Carlotta& Graziadio, Chiara& Giannetta, Elisa& Lenzi, Andrea& Isidori, Andrea Maria. Management Strategies for Aggressive Cushing's Syndrome : From Macroadenomas to Ectopics. Journal of Oncology. 2012. Vol. 2012, no. 2012, pp.1-9.
https://search.emarefa.net/detail/BIM-490432
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-490432