Ectopic ACTH syndrome in APUD tumors

Rapidly progressing hypercorticism was observed in 2 patients with malignant neoplasms, a 72-year-old man with anaplastic small cell carcinoma and a 48-year-old woman with a primary apudoma of the liver. Both patients were treated with chemotherapy in conventional doses. Both patients developed acute dyspnea and sudden death, 7 and 10 days, respectively, after chemotherapy was given. The possibility that patients with ectopic adrenocorticotropic hormone (ACTH) secretion are excessively vulnerable to chemotherapy is raised and judicious management urged.