A case of recurrent non-small-cell lung carcinoma and paraneoplastic Cushing's syndrome

Abstract

Summary Secretion of ectopic adrenocorticotropic hormone (ACTH) with consequently Cushing's syndrome is a rare paraneoplastic phenomenon. It has been described in a variety of malignancies, like bronchial carcinoids, small-cell lung carcinoma, thymoma, pancreatic carcinoma and other. In many cases of suspected ectopic ACTH secretion, it is difficult to histologically or cytochemically confirm the diagnosis. We present a 63-year-old woman with a recurrent poorly differentiated squamous cell lung carcinoma with clinical and biochemical features consistent with ectopic Cushing's syndrome. Immunocytochemical staining confirmed the secretion of ACTH by tumour cells.

Development of Cushing's Syndrome During Effective Chemotherapy for Small Cell Lung Cancer

“…In the recent literature, the incidence of SCLC associated with paraneoplastic syndrome has seemed to decrease (2). A possible explanation for this trend might be the recent improvements in diagnosis, chemotherapy, and radiotherapy.…”

Cushing's syndrome secondary to bronchopulmonary carcinoid tumor: Report of two cases and literature review

“…Ectopic ACTH secretion has been described in a wide number of neoplasms: non-small-cell lung carcinoma [9], small-cell lung carcinoma, carcinoid tumors (bronchopulmonary, thymic and gastrointestinal origin), pancreatic islet tumors, pheocromocytoma, thyroid's medullary carcinoma [18] and a host of other tumors, such as paraganglioma [19], prostate [20], breast [21,22], kidneys [23], stomach [24], ovaries [25], melanoma [26], colon [27], leukemia [28], anorectal tumors [29], and even in inflammatory tissues [30]. Among these, the bronchopulmonary carcinoid tumor remains the most prevalent [18].…”

“…Ten per cent of CS cases are secondary to non-pituitary neoplasms, such as the bronchopulmonary carcinoid tumors and, occasionally, non-small-cell lung tumor [9]. In both cases there is production of excessive amounts of ectopic ACTH.…”

Hypertension and severe hypokalaemia associated with ectopic ACTH production

“…Harvey Cushing (1869–1939) described in 1912 an endocrine syndrome caused by pituitary overproduction of adrenocorticotropic hormone (ACTH) 2. In patients with Cushing’s syndrome (CS), an ectopic secretion of ACTH comprises about 5%–10% of cases, and approximately 50%–60% of these are neuroendocrine lung tumours, such as small-cell lung cancer (SCLC) 1 3 4.…”