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[Small cell lung cancer associated with ectopic ACTH syndrome]
K Takano1, K Takayama, H Nakano
1Research Institute for Diseases of the Chest, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi
|February 1, 1996
Summary
This study details a case of small cell lung cancer presenting with paraneoplastic Cushing's syndrome. While chemotherapy initially achieved a complete response, the cancer relapsed, leading to the patient's death.
Area of Science:
- Oncology
- Endocrinology
Background:
- Small cell lung cancer (SCLC) is an aggressive form of lung cancer.
- Paraneoplastic syndromes occur in cancer patients and can significantly impact their presentation and treatment.
Observation:
- A 70-year-old woman with a pulmonary mass was diagnosed with SCLC.
- She presented with classic signs of Cushing's syndrome, including elevated ACTH and cortisol levels, hypokalemia, metabolic alkalosis, hyperglycemia, obesity, hypertension, and pigmentation.
Findings:
- Immunohistochemistry confirmed ACTH production by metastatic tumor cells.
- The patient achieved a complete response to chemotherapy (VP-16, CBDCA, CDDP) with rapid normalization of ACTH levels.
- Tumor relapse occurred after 3 months, resulting in disease progression and death 11 months post-diagnosis.
Implications:
- This case highlights the importance of recognizing and managing paraneoplastic Cushing's syndrome in SCLC.
- Effective chemotherapy can induce remission, but long-term survival remains a challenge due to the high risk of relapse.