METASTATIC PANCREATIC NEUROENDOCRINE CARCINOMA CAUSING CUSHINGS-SYNDROME

Conclusion: Following resection of a nonfunctioning neuroendocrine car cinoma of the pancreas, subsequent metastases, in the absence of a pri mary cancer (resected), developed the capacity to secrete ACTH and cre ate the Cushing syndrome. Background: Although neuroendocrine carcinom as of the pancreas may produce one or more hormones and may switch sec retion to a different hormone, no report is identified of a metastasis , in the absence of the primary tumor, developing de novo the capacity to secrete ACTH. Methods: A nonfunctioning islet cell carcinoma was r esected and immunochemically stained for multiple hormones. Three year s later hepatic metastases were partially resected and stained as befo re. Results: The primary cancer stained negative for ACTH and cortisol , positive for serotonin, and focally positive for gastrin. Three year s later, after the development of a florid Gushing syndrome, the metas tasis stained strongly for ACTH and negative for serotonin.