Carcinoid syndrome associated with adrenal hyperplasia.

Abstract

It is now recognized that there is considerable variation in the clinical manifestations,^1,2the origin, and character of metastatic carcinoid tumors. A malabsorption syndrome³and scleroderma⁴may accompany the carcinoid syndrome. This syndrome may be produced by bronchial carcinoids with metastases,^5-8oat-cell carcinoma,⁹argentaffinoma of the lung without hepatic metastases,¹⁰and pancreatic carcinoma with demonstrated 5-hydroxytryptophan decarboxylase activity.¹¹The syndrome is apparent in only 20% of patients with carcinoid tumors and hepatic metastases¹²and may rarely be associated with normal levels of 5-hydroxyindoleacetic acid (5-HIAA) excretion in the urine.^13,14 The possible association of carcinoid syndrome and Cushing's syndrome has been suggested by the report of Harrison¹⁵of a patient with bronchial carcinoma and clinical features of adrenal hyperplasia. In their patient 17-ketosteroid excretion was normal and 5-HIAA excretion in the urine was moderately increased as shown by paper chromatography.