The Mount Sinai Clinical Pathway for the Diagnosis and Management of Hypercortisolism due to Ectopic ACTH Syndrome

被引：12

作者：

Alba, Eva L. ^{[1
]}

Japp, Emily A. ^{[2
]}

Fernandez-Ranvier, Gustavo ^{[3
]}

Badani, Ketan ^{[4
]}

Wilck, Eric ^{[5
]}

Ghesani, Munir ^{[5
]}

Wolf, Andrea ^{[6
]}

Wolin, Edward M. ^{[7
]}

Corbett, Virginia ^{[8
]}

Steinmetz, David ^{[3
]}

Skamagas, Maria ^{[1
]}

Levine, Alice C. ^{[1
]}

机构：

[1] Icahn Sch Med Mt Sinai, Adrenal Ctr, Div Endocrine Diabet & Bone Dis, Dept Med, New York, NY 10029 USA

[2] Univ Maryland, Sch Med, Div Endocrinol Diabet & Nutr, Dept Med, Baltimore, MD USA

[3] Icahn Sch Med Mt Sinai, Div Metab Endocrine & Minimally Invas Surg, Dept Surg, New York, NY 10029 USA

[4] Icahn Sch Med Mt Sinai, Div Urol, Dept Surg, New York, NY 10029 USA

[5] Icahn Sch Med Mt Sinai, Dept Diagnost Mol & Intervent Radiol, New York, NY 10029 USA

[6] Icahn Sch Med Mt Sinai, Div Thorac Surg, Dept Surg, New York, NY 10029 USA

[7] Icahn Sch Med Mt Sinai, Tisch Canc Inst, Ctr Carcinoid & Neuroendocrine Tumors, Div Hematol & Oncol,Dept Med, New York, NY 10029 USA

[8] Icahn Sch Med Mt Sinai, Div Hematol & Oncol, Dept Med, New York, NY USA

来源：

JOURNAL OF THE ENDOCRINE SOCIETY | 2022年 / 6卷 / 07期

关键词：

hypercortisolism; Cushing syndrome; ectopic ACTH; CUSHINGS-SYNDROME; NEUROENDOCRINE TUMORS; DIFFERENTIAL-DIAGNOSIS; CARDIOVASCULAR RISK; HORMONE SYNDROME; RAPID CONTROL; SECRETION; ADRENALECTOMY; SUPPRESSION; EXPERIENCE;

D O I：

10.1210/jendso/bvac073

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Neoplasms that secrete ectopic adrenocorticotropin (ACTH) may cause severe, life-threatening hypercortisolism. These tumors are often difficult to localize and treat, requiring a comprehensive and systematic management plan orchestrated by a multidisciplinary team. The Mount Sinai Adrenal Center hosted an interdisciplinary retreat of experts in adrenal disorders and neuroendocrine tumors (NETs) with the aim of developing a clinical pathway for the management of Cushing syndrome due to ectopic ACTH production. The result was institutional recommendations for the diagnosis, localization, surgical approaches to intrathoracic tumors and bilateral adrenalectomy, and perioperative and postoperative medical management of hypercortisolism and its sequelae. Specific recommendations were made regarding the timing and selection of therapies based on the considerations of our team as well as a review of the current literature. Our clinical pathway can be applied by other institutions directly or serve as a guide for institution-specific management.

引用

页数：10

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