Small cell lung cancer associated with ectopic ACTH syndrome

K. Takano, K. Takayama, H. Nakano, N. Hagimoto, Y. Nakanishi, N. Hara

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Abstract

A 70-year-old woman was referred to our hospital for diagnosis and treatment of a pulmonary mass detected on a chest X-ray film. Small cell lung cancer was diagnosed from pathological examination of a specimen of the tumor obtained by transbronchial biopsy. Paraneoplastic Cushing's syndrome was diagnosed on the basis of an elevated serum ACTH level (2000 pg/ml), the serum cortisol level (171.9 μg/dl), elevated excretion of urinary 17 OHCS (67 mg/day), persistent hypokalemia, metabolic alkalosis, hyperglycemia, central obesity, hypertension, systemic pigmentation, and the lack of a history of diabetes mellitus. Immunohistochemical staining with a polyclonal anti-ACTH antibody of a biopsy specimen from a lymph node with metastasis showed that tumor cells were weakly positive. The patient responded well to intensive chemotherapy with VP-16 (100 mg/m2 day 103), CBDCA (100 mg/m2 day 1-3), and CDDP (80 mg/m2 day 1). Complete response was obtained after 6 courses of chemotherapy. The serum ACTH level decreased rapidly as the tumor shrank. The primary tumor, however, relapsed after 3 months and the patient died of progressive disease, 11 months after diagnosis.

Original languageEnglish
Pages (from-to)220-225
Number of pages6
JournalJapanese Journal of Thoracic Diseases
Volume34
Issue number2
Publication statusPublished - Apr 26 1996

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

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