Treatment‐related neuroendocrine prostate cancer resulting in Cushing's syndrome. (21st October 2016)

• Record Type: Journal Article
• Authors: Ramalingam, Sundhar; Eisenberg, Adva; Foo, Wen Chi; Freedman, Jennifer; Armstrong, Andrew J; Moss, Larry G; Harrison, Michael R
• Is Part Of: International journal of urology. Volume 23:Number 12(2016)
• Page Start: 1038
• Page End: 1041
• Publication Date: 2016-10-21
• Subjects: castration‐resistant -- Cushing's syndrome -- neuroendocrine transdifferentiation -- paraneoplastic syndrome -- prostate cancer; Urology -- Periodicals; Genitourinary organs -- Periodicals; Urologic Diseases -- Periodicals; 616.6005
• DOI: 10.1111/iju.13225
• Languages: English
• ISSNs: 0919-8172

Abstract

Abstract: Here we present, to the best of our knowledge, the first case of a paraneoplastic Cushing's syndrome (hypercortisolism) resulting from treatment‐related neuroendocrine prostate cancer – a highly aggressive and difficult disease to treat. A 51‐year‐old man was started on androgen deprivation therapy after presenting with metastatic prostate cancer, characterized by diffuse osseous metastasis. Shortly thereafter, he developed progressive disease with biopsy proven neuroendocrine prostate cancer as well as symptoms of increased skin pigmentation, hypokalemia, hypertension, hyperglycemia and profound weakness, consistent with ectopic Cushing's syndrome. Molecular analysis of the patient's tumor through RNA sequencing showed high expression of several genes including CHGA, ASCL1, CALCA, HES6, PCSK1, CALCB and INSM1 confirming his neuroendocrine phenotype; elevated POMC expression was found, supporting the diagnosis of ectopic Cushing's syndrome.