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Mifepristone for ectopic adrenocroticotropin secretion in metastatic endocrine carcinomas: report of two cases.

P Cassier, Medical Oncology, Hopital Edouard Herriot, Lyon, 69003, France
S Abou-Amara-Olivieri, Endocrinology, Hopital Edouard Herriot, Lyon, France
P Artru, Gastroenterology, Clinique Saint Jean, Lyon, France
M Lapalus, Gastroenterology, Hopital Edouard Herriot, Lyon, France
J Riou, Department of Endocrinology, Hopital Edouard Herriot, lyon, France
C Lombard-Bohas, Medical Oncology, Hopital Edouard Herriot, Lyon, France

Correspondence: Philippe Cassier, Email: cassierp{at}hotmail.com

Abstract

Ectopic adrenocorticotropin secretion (EAS) remains a therapeutic challenge whenever the tumor responsible for the syndrome is not amenable to curative resection. Two cases of EAS related to metastatic foregut-derived endocrine carcinomas led us to use mifepristone, an antagonist of both progesterone and glucocorticoids. Mifepristone clearly improved skin lesions and diabetes associated with hypercorticism. The beneficial effect lasted for about 10 months. In both cases, recurrent hypertension and hypokalemia eventually required adrenalectomy.