{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T00:28:50Z","timestamp":1648686530477},"reference-count":19,"publisher":"FapUNIFESP (SciELO)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Bras Endocrinol Metab"],"published-print":{"date-parts":[[2005,10]]},"abstract":"<jats:p>A s\u00edndrome de Cushing (SC) por ACTH ect\u00f3pico \u00e9 um dist\u00farbio com alta morbi\/mortalidade, cujo manejo necessita de medidas terap\u00eauticas r\u00e1pidas e eficientes. Os tumores carcin\u00f3ides produtores de ACTH (TuCA-ACTH) apresentam quadro ainda mais grave em decorr\u00eancia dos dist\u00farbios associados \u00e0 s\u00edndrome carcin\u00f3ide (SCA) que acentuam as repercuss\u00f5es do hipercortisolismo. Assim, o manejo de pacientes com TuCA-ACTH deve incluir o controle do hipercortisolismo e do dist\u00farbio carcin\u00f3ide, sendo escassas informa\u00e7\u00f5es que abordam tais estrat\u00e9gias. Relatamos 3 pacientes (2F, 1M) com TuCA-ACTH (2 pancre\u00e1ticos e 1 oculto) que apresentavam manifesta\u00e7\u00f5es cl\u00ednicas de SC (n= 3) e SCA (n= 2): 2 foram investigados inicialmente por apresentarem SC e um, SCA. Em todos ocorreu hipocalemia espont\u00e2nea, hipertens\u00e3o arterial e diabetes mellitus, sendo demonstrada a presen\u00e7a de hipercortisolismo severo e eleva\u00e7\u00e3o de ACTH. A administra\u00e7\u00e3o de octreotide-LAR reduziu os n\u00edveis de ACTH de 230.000 para 30.000pg\/ml no caso 1, e controlou os sintomas da SCA e das les\u00f5es neopl\u00e1sicas no caso 2, enquanto o octreotide subcut\u00e2neo controlou a SCA e reduziu parcialmente os sintomas do hipercortisolismo no caso 3. Os 3 pacientes foram adrenalectomizados bilateralmente, medida essencial para o controle da SC (desaparecimento da hipocalemia, miopatia, hipertens\u00e3o arterial e diabetes mellitus). Nossos dados demonstram que a associa\u00e7\u00e3o destas estrat\u00e9gias, em conjunto com terapias anti-neopl\u00e1sicas, pode contribuir para estabiliza\u00e7\u00e3o e\/ou controle definitivo dos TuCA-ACTH.<\/jats:p>","DOI":"10.1590\/s0004-27302005000500020","type":"journal-article","created":{"date-parts":[[2006,2,10]],"date-time":"2006-02-10T14:05:59Z","timestamp":1139580359000},"page":"791-796","source":"Crossref","is-referenced-by-count":0,"title":["Octreotide-LAR + adrenalectomia bilateral no manejo de tumores carcin\u00f3ides produtores de ACTH"],"prefix":"10.1590","volume":"49","author":[{"given":"Mauro A.","family":"Czepielewski","sequence":"first","affiliation":[{"name":"UFRGS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maikel","family":"Colli","sequence":"additional","affiliation":[{"name":"UFRGS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatiana","family":"Harlos","sequence":"additional","affiliation":[{"name":"UFRGS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra Pinho","family":"Silveiro","sequence":"additional","affiliation":[{"name":"UFRGS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Maraschin","sequence":"additional","affiliation":[{"name":"UFRGS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Copette","sequence":"additional","affiliation":[{"name":"UFRGS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristiane B.","family":"Leit\u00e3o","sequence":"additional","affiliation":[{"name":"UFRGS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guilherme A.F.S.","family":"Rollin","sequence":"additional","affiliation":[{"name":"UFRGS"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"issue":"89","key":"ref1","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1177\/030089160308900201","article-title":"Current treatments of neuroendocrine tumors role of biotherapy and chemotherapy","author":"Della Torre S","year":"2003","journal-title":"Tumori","ISSN":"http:\/\/id.crossref.org\/issn\/0300-8916","issn-type":"print"},{"issue":"97","key":"ref2","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1002\/cncr.11105","article-title":"A 5-decade analysis of 13,715 carcinoid tumors","author":"Modlin IM","year":"2003","journal-title":"Cancer","ISSN":"http:\/\/id.crossref.org\/issn\/0008-543X","issn-type":"print"},{"issue":"340","key":"ref3","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1056\/NEJM199903183401107","article-title":"Carcinoid tumors","author":"Kulke MH","year":"1999","journal-title":"N Engl J Med","ISSN":"http:\/\/id.crossref.org\/issn\/0028-4793","issn-type":"print"},{"key":"ref4","series-title":"Williams Textbook of Endocrinology","first-page":"1857","volume-title":"Carcinoid tumors, carcinoid syndrome and related disorders","author":"Oberg K","year":"2003","edition":"10th"},{"issue":"65","key":"ref5","doi-asserted-by":"crossref","first-page":"2227","DOI":"10.1002\/1097-0142(19900515)65:10<2227::AID-CNCR2820651011>3.0.CO;2-C","article-title":"Hepatic arterial embolization for metastatic hormone-secreting tumors. 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