title: Gastric adenocarcinoma associated with lymphangitis carcinomatosa, adrenal metastasis with ectopic ACTH syndrome and malignant common bile duct stricture.
abstract: Ectopic adrenocorticotrophic hormone (ACTH) syndrome (EAS) commonly occurs secondary to neuroendocrine tumours and small cell carcinoma of lung. EAS has also been reported in association with gastric carcinoids. But, the occurrence of EAS secondary to gastric adenocarcinoma has rarely been reported. A 45-year-old male patient from Bangladesh presented with abdominal pain, jaundice and hyperpigmentation. Extensive work-up revealed poorly differentiating mucin-secreting adenocarcinoma of stomach with lymphangitis carcinomatosa of lung, bilateral adrenal metastasis and malignant common bile duct (CBD) stricture. Laboratory reports were suggestive for ectopic ACTH production. Most of these features are very rare in adenocarcinoma of stomach, and all these rare events occurring in a single patient is probably the rarest.
authors.affiliation: Department of General Medicine, Medical College Kolkata, West Bengal, India. dr.pradipta@yahoo.co.in
authors.forename: Pradipta
authors.initials: P
authors.lastname: Guha
authors.forename: Shivesh Shankar
authors.initials: SS
authors.lastname: Sahai
authors.forename: Debasis
authors.initials: D
authors.lastname: Sarkar
authors.forename: Partha
authors.initials: P
authors.lastname: Sardar
authors.forename: Biplab
authors.initials: B
authors.lastname: Mandal
authors.forename: Bidyut Kumar
authors.initials: BK
authors.lastname: Das
authors.forename: Sanjoy Kumar
authors.initials: SK
authors.lastname: Chatterjee
mesh_terms: D000182:ACTH Syndrome, Ectopic / Q000175:diagnosis*; D000230:Adenocarcinoma / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000556:secondary; D003138:Common Bile Duct Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000556:secondary; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D041781:Jaundice, Obstructive / Q000175:diagnosis / Q000209:etiology; D008205:Lymphangitis / Q000175:diagnosis* / Q000209:etiology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology