Cushing's syndrome induced by bronchopulmonary carcinoid tumours: a review of 98 cases and our experience of two cases.

Bronchopulmonary carcinoids are one of the most common cause of ectopic secretion of corticotropin (ACTH) and account for approximately 1% of all the patients in whom Cushing's syndrome develops. We reviewed 98 cases described in the World Literature and we report on two new cases. A 60-year old woman affected by Cushing's syndrome underwent to surgical wedge resection of a peripheral pulmonary nodule and a 30-year old woman with similar clinical features underwent to middle lobectomy for a small hilar neoplasm. Histopathologic examination of the tumours defined them as typical bronchopulmonary carcinoids. The patients are asymptomatic and with no sign of recurrence 72 and 30 months after surgery. According to our review we found no clear evidence that bronchial carcinoids associated with Cushing's syndrome should be considered a more aggressive variant or subtype of the typical carcinoid. If Cushing's syndrome does not disappear after surgery, the presence of residual disease (often a nodal involvement) should be investigated. A long-term relapse of the syndrome requires a careful search for local or distant neoplastic recurrence.