A CASE OF SMALL-CELL CARCINOMA OF THE UTERINE CERVIX PRESENTING CUSHINGS-SYNDROME

A proportion of small cell carcinoma of the uterine cervix is known to secrete a neuroendocrine substance. However, cases presenting Gushing 's syndrome due to ACTH secreted from a cervical small cell carcinoma are extremely rare, Here, we report a case of small cell carcinoma of the uterine cervix that ectopically secreted ACTH and presented Gushin g's syndrome, A 42-year-old woman was initially admitted to the endocr ine unit for investigation of ectopic ACTH syndrome. Serum cortisol an d plasma ACTH levels were elevated with no diurnal variation, After gy necologic examination, her original disease was found to be a stage II b cervical small cell carcinoma, She underwent a radical hysterectomy and pelvic lymphadenectomy, The entire tumor was excised and post-TNM classification was T2bN1M0. Immunohistochemically, tumor cells stained strongly for ACTH and chromogranin. Electron-microscopic pictures sho wed typical neurosecretory granules, Although plasma ACTH returned to normal after surgery, liver metastasis appeared during the course of p ostoperative irradiation. She died 9 months after operation in spite o f vigorous systemic chemotherapy. (C) 1996 Academic Press, Inc.