Small cell carcinoma with two paraendocrine syndromes

Abstract

Simultaneous elevated levels of ectopic arginine vasopressin (AVP) and ectopic adrenocorticotropin (ACTH) were found in a patient with small cell carcinoma (SCC). The finding of one of these paraendocrine syndromes at the time of diagnosis is common; however, the simultaneous presence of both syndromes has been reported in the literature only on four occasions in the past 25 years. This is the only report in which elevated plasma levels of both hormones are documented in a patient who simultaneously fulfills the criteria for the syndrome associated with each ectopically produced peptide. In the English‐language literature, this is the first case that demonstrates by immunohistochemical staining the presence of both of these hormones in the patient's neoplasm. In addition to the use of radiographs, the presence of paraendocrine disorders can provide a method of monitoring the patient's response to therapy. The levels of ACTH and AVP were assayed during this patient's course and correlated with disease refractory to therapy, resulting in poor survival.

Long-term Survival of a Patient with Small Cell Lung Cancer Secreting ADH and ACTH Simultaneously, Following the Prolonged Use of Amrubicin

“…It is noteworthy that thus far, there have been only nine reported cases wherein SCLC produced these two hormones simultaneously (2,(6)(7)(8)(9)(10)(11)(12)(13). According to these reports, the opposing effects of cortisol and ADH on renal sodium excre-tion sometimes complicate the diagnosis or result in a misdiagnosis.…”

“…According to these reports, the opposing effects of cortisol and ADH on renal sodium excre-tion sometimes complicate the diagnosis or result in a misdiagnosis. In addition, the presence of these paraneoplastic syndromes is indicative of a poor prognosis in SCLC patients, with overall survival of only 2-4 months (2,(6)(7)(8)(9)13).…”

Beyond the Dual Paraneoplastic Syndromes of Small-Cell Lung Cancer with ADH and ACTH Secretion: A Case Report with Literature Review and Future Implications

“…Eight cases of SCLC [ 7 – 14 ] with dual SIADH and EAS described in literature are summarized in Table 2 . Six [ 7 , 9 – 11 , 13 , 14 ] out of eight cases did not have typical Cushingoid picture and presented with weight loss and SAME. We notice that dual SIADH and EAS in SCLC can be simultaneous or sequential with the latter carrying worse prognosis and shorter life expectancy compared to simultaneous disease.…”

Multiple endocrine paraneoplastic syndromes in a patient with lung malignancy

“…1 Clinically apparent Cushing's syndrome is less common and the simultaneous presence of SIADH and ectopic ACTH is rarely reported, with only 6 cases described in the literature. 2,3 Hyponatraemia occurs frequently in hospitalised patients and is often underinvestigated. 4 Humayan et al demonstrated that hyponatraemia due to any cause but responsive only to tolvaptan was associated with increased mortality.…”