[Ectopic ACTH syndrome in bronchopulmonary tumors (author's transl)]

Thirteen cases of bronchopulmonary carcinomas without symptoms of hypercorticoidism, hypopotassemic alkalosis, or intolerance to an overdose of glucose are described. Repeated circadian rhythm and the suppression test with small doses of dexamethasone were practiced on each one. In 7 cases the secretion of cortisol was supressed normally with oral administration of dexametahsone. In the other 6 cases the circadian rhythm was lost and it was imposible to reduce the plasma level of cortisol with dexamethasone. The results help to point out the usefulness of these easy to perform dynamic tests as a means of diagnosing the ectopic production of ACTH by bronchopulmonary tumors. At the same time they show the relatively high incidence of production of this hormone by this type of tumors in patients who have no symptoms of classical hypercorticoidism. The determination of plasma cortisol levels using this test could be valuable in establishing the prognosis and clinical course of the disease. A normalization of the endogenous adrenal secretion of glucocorticoids would indicate a regression of the tumor in response to treatment.