ECTOPIC ACTH SYNDROME AND CRH-MEDIATED CUSHINGS-SYNDROME

The ectopic ACTH syndrome accounts for a substantial number of patients with naturally occurring Cushing's syndrome. Patients with either ectopic ACTH syndrome or the rare CRH-mediated Cushing's syndrome may be indistinguishable from patients with pituitary ACTH Cushing's syndrome, based on clinical grounds or simple biochemical and radiologic testing. Because their therapies differ, accurate diagnosis is essential. While clinical researchers continue to develop more effective diagnostic techniques and therapies, further advances in the molecular and cell biology of ACTH and CRH-producing tumors will undoubtedly shed light on the pathogenesis of this perplexing, fascinating, and controversial entity.