title: Small-cell Lung Cancer in a Young Adult Nonsmoking Patient with Ectopic Adrenocorticotropin (ACTH) Production.
abstract: Cushing's syndrome due to young small-cell lung cancer (SCLC) is recognized as being extremely rare. We herein present the case of a 35-year-old nonsmoking man who presented with thirst and polyuria. Laboratory examinations showed hyperglycemia, hypokalemia and liver enzyme elevation. Imaging examinations revealed the presence of multiple liver tumors and lymph node swelling. The levels of serum neuroendocrine tumor markers were elevated. The patient was diagnosed with SCLC based on the pathological examination of a biopsy specimen from the right supraclavicular lymph node. The physical findings, including proximal myopathy, truncal obesity and pigmentation suggested high levels of glucocorticoids. An immunohistochemical examination of the tumor showed that it was positive for adrenocorticotropin (ACTH). An endocrinological investigation allowed for the definitive diagnosis of SCLC with ectopic ACTH production.
authors.affiliation: Internal Medicine of Gastroenterology, First Towakai Hospital, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Aoki
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Fujisaka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tokioka
authors.forename: Ai
authors.initials: A
authors.lastname: Hirai
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Henmi
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Inoue
authors.forename: Ken
authors.initials: K
authors.lastname: Narabayashi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamano
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Tamura
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Egashira
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Higuchi
mesh_terms: D000182:ACTH Syndrome, Ectopic / Q000175:diagnosis / Q000209:etiology*; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D006801:Humans; D007008:Hypokalemia; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D055752:Small Cell Lung Carcinoma / Q000150:complications* / Q000175:diagnosis / Q000473:pathology
chemical_list: D000324:Adrenocorticotropic Hormone