A Case of Ectopic Adrenocorticotropic Hormone Syndrome in Small Cell Lung Cancer.
Small cell lung cancer (SCLC), which originated from neuroendocrine tissue, can develop into paraneoplastic endocrine syndromes, such as Cushing syndrome, because of an inappropriate secretion of ectopic adrenocorticotropic hormone (ACTH). This paraneoplastic syndrome is known to be a poor prognostic factor in SCLC. The reason for poor survival may be because of a higher risk of infection associated with hypercortisolemia. Therefore, early detection and appropriate treatment for this syndrome is necessary. But the diagnosis is challenging and the source of ACTH production can be difficult to identify. We report a 69-year-old male patient who had severe hypokalemia, metabolic alkalosis, and hypertension as manifestations of an ACTH-secreting small cell carcinoma of the lung. He was treated with ketoconazole and spironolactone to control the ACTH dependent Cushing syndrome. He survived for 15 months after chemotherapy, which is unusual considering the poor outcome of the ectopic ATH syndrome associated with SCLC.
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Chaiho
C
Jeong
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Jinhee
J
Lee
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Seongyul
S
Ryu
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Hwa Young
HY
Lee
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Ah Young
AY
Shin
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Ju Sang
JS
Kim
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Joong Hyun
JH
Ahn
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Hye Seon
HS
Kang
ACTH Syndrome, Ectopic; Paraneoplastic Syndromes; Small Cell Lung Carcinoma