False-positive inferior petrosal sinus sampling in the diagnosis of Cushing's disease: Report of two cases

Y. Yamamoto, D. H. Davis, T. B. Nippoldt, W. F. Young, J. Huston, J. E. Parisi

Research output: Contribution to journalArticle

70 Scopus citations

Abstract

Inferior petrosal sinus sampling (IPSS) for adrenocorticotropic hormone (ACTH) levels in patients with Cushing's syndrome has become a useful method to distinguish ACTH-secreting pituitary tumors (Cushing's disease) from other causes of the syndrome, principally ectopic adrenocorticotropin secretion by an occult tumor. Although the test is generally regarded as highly specific, the authors recently encountered two patients whose IPSS measurements were false-positive for Cushing's disease. The results of IPSS suggested a pituitary origin of ACTH secretion in both patients, but transsphenoidal surgery failed to disclose a pituitary adenoma or to improve postoperative plasma cortisol levels. Both patients subsequently were found to have an ACTH-secreting carcinoid tumor of the lung. The false-positive IPSS studies were due to periodic hormonogenesis. The patients must he hypercortisolemic at the time IPSS is performed for the study to be valid.

Original languageEnglish (US)
Pages (from-to)1087-1091
Number of pages5
JournalJournal of neurosurgery
Volume83
Issue number6
DOIs
StatePublished - Jan 1 1995

Keywords

  • Cushing's disease
  • Cushing's syndrome
  • carcinoid tumor
  • inferior petrosal sinus sampling

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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