Small cell lung cancer with panhypopituitarism due to ectopic adrenocorticotropic hormone syndrome: A case report  

作　　者：Ting Jin Fang Wu Shui-Ya Sun Fen-Ping Zheng Jia-Qiang Zhou Yi-Ping Zhu Zhou Wang 

机构地区：[1]Department of Endocrinology,Zhejiang University School of Medicine Sir Run Run Shaw Hospital,Hangzhou 310016,Zhejiang Province,China [2]Department of General Surgery,Zhejiang University School of Medicine Sir Run Run Shaw Hospital,Hangzhou 310016,Zhejiang Province,China

出　　处：《World Journal of Clinical Cases》2019年第10期1177-1183,共7页世界临床病例杂志

基　　金：Supported by the National Science Foundation for Youth,No.30800533;the Public Welfare Project of Science and Technology Department of Zhejiang Province,China,No.2017C33056

摘　　要：BACKGROUND Small cell lung cancer(SCLC)accounts for 15%of lung cancers,and it commonly expresses peptide and protein factors that are active as hormones.These secreting factors manifest as paraneoplastic disorders,such as ectopic adrenocorticotropic hormone(ACTH)syndrome(EAS).The clinical features are abnormalities in carbohydrate metabolism,hypokalemia,peripheral edema,proximal myopathy,hypertension,hyperpigmentation,and severe systemic infection.However,it is uncommon that EAS has an influence on hypothalamus-pituitary function.CASE SUMMARY A 62-year-old man presented with complaints of haemoptysis,polyuria,polydipsia,increased appetite,weight loss,and pigmentation.Following a series of laboratory and imaging examinations,he was diagnosed with SCLC,EAS,hypogonadism,hypothyroidism,and central diabetes insipidus.After three rounds of chemotherapy,levels of ACTH,cortisol,thyroid hormone,gonadal hormone,and urine volume had returned to normal levels.In addition,the pulmonary tumor was reduced in size.CONCLUSION We report a rare case of SCLC complicated with panhypopituitarism due to EAS.We hypothesize that EAS induced high levels of serum glucocorticoid and negative feedback for the synthesis and secretion of antidiuretic hormone from the paraventricular nucleus,and trophic hormones from the anterior pituitary.Therefore,patients who present with symptoms of hypopituitarism,or even panhypopituitarism,with SCLC should be evaluated for EAS.BACKGROUND Small cell lung cancer(SCLC) accounts for 15% of lung cancers, and it commonly expresses peptide and protein factors that are active as hormones. These secreting factors manifest as paraneoplastic disorders, such as ectopic adrenocorticotropic hormone(ACTH) syndrome(EAS). The clinical features are abnormalities in carbohydrate metabolism, hypokalemia, peripheral edema, proximal myopathy,hypertension, hyperpigmentation, and severe systemic infection. However, it is uncommon that EAS has an influence on hypothalamus-pituitary function.CASE SUMMARY A 62-year-old man presented with complaints of haemoptysis, polyuria,polydipsia, increased appetite, weight loss, and pigmentation. Following a series of laboratory and imaging examinations, he was diagnosed with SCLC, EAS,hypogonadism, hypothyroidism, and central diabetes insipidus. After three rounds of chemotherapy, levels of ACTH, cortisol, thyroid hormone, gonadal hormone, and urine volume had returned to normal levels. In addition, the pulmonary tumor was reduced in size.CONCLUSION We report a rare case of SCLC complicated with panhypopituitarism due to EAS.We hypothesize that EAS induced high levels of serum glucocorticoid and negative feedback for the synthesis and secretion of antidiuretic hormone from the paraventricular nucleus, and trophic hormones from the anterior pituitary.Therefore, patients who present with symptoms of hypopituitarism, or even panhypopituitarism, with SCLC should be evaluated for EAS.

关 键 词：Small cell LUNG cancer ECTOPIC adrenocorticotropic HORMONE SYNDROME PANHYPOPITUITARISM Case report 

分 类 号：R[医药卫生]