Cushing's syndrome in prostate cancer - An aggressive course of prostatic malignancy

We report a case with an initial diagnosis of adenocarcinoma of the prostat e in whom Gushing's syndrome developed. The disease did not respond to estr ogen treatment and the patient died of severe septicemia. Histopathologic e xamination of the autopsy specimens revealed a small cell carcinoma intermi ngled with a moderately differentiated adenocarcinoma in the prostate and w idespread metastases of small cell carcinoma. Immunoreactivity for neuroend ocrine differentiation was found only in the small cell carcinoma. Determin ation of different tumor markers in plasma samples showed markedly elevated levels of prostate-specific antigen as well as carcinoembryonic antigen pr ior to treatment, with no significant changes after treatment. The concentr ation of the neuroendocrine marker chromogranin A was initially within the normal range, but increased during estrogen treatment, whilst neuron-specif ic enolase was moderately elevated throughout the observation period. Copyr ight (C) 1999 S. Karger AG, Basel.