A Case of Ectopic Adrenocorticotropic Hormone Syndrome in Small Cell Lung Cancer

• Published in: Tuberculosis and respiratory diseases Vol. 78; no. 4; pp. 436 - 439
• Main Authors: Jeong, Chaiho, Lee, Jinhee, Ryu, Seongyul, Lee, Hwa Young, Shin, Ah Young, Kim, Ju Sang, Ahn, Joong Hyun, Kang, Hye Seon
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Tuberculosis and Respiratory Diseases 01.10.2015; 대한결핵및호흡기학회
• Subjects: Case Report; 내과학; Small Cell Lung Carcinoma; Paraneoplastic Syndromes; ACTH Syndrome, Ectopic
• ISSN: 1738-3536; 2005-6184
• DOI: 10.4046/trd.2015.78.4.436

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.