Ostalo

Ectopic ACTH secretion with concomitant hyperamylasemia in a patient with small cell lung carcinoma: case report

Ivan Čekerevac ; Clinical Department of Pulmonology, Kragujevac, Serbia
Marina Petrović ; Clinical Department of Pulmonology, Kragujevac, Serbia; University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia
Ljiljana Novković ; Clinical Department of Pulmonology, Kragujevac, Serbia
Dragana Bubanja ; Clinical Department of Internal Medicine, Kragujevac Clinical Center, Kragujevac, Serbia
Ivan Bubanja ; Clinical Department of Internal Medicine, Kragujevac Clinical Center, Kragujevac, Serbia
Bojan Djokić ; Clinical Department of Internal Medicine, Kragujevac Clinical Center, Kragujevac, Serbia
Vesna Stanković ; University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia
Vladimir Jurišić orcid.org/0000-0001-6525-128X ; University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia

Sažetak

Histologically confirmed small cell lung cancer associated with Cushing’s syndrome and elevated amylase is rarely described in the literature. We present a case of a 63-year-old patient admitted to cardiology department due to shortness of breath, exhaustion, palpitations and nausea. Elevated values of troponin and electrocardiography suggested that he could have acute coronary syndrome. According to the radiologist’s opinion, plane lung radiography was normal. Elevated level of amylase was found in both serum (3802 U/L, normal range 28-100) and urine (12012 U/L, normal range 0-450 U/L), as well as elevated sodium (156 mmol/L, normal range 137-147 mmol/L), hyperglycemia (12 mmol/L, normal range 3.8-6.1 mmol/L) and lowered serum potassium (1.7 mmol/L, normal range 3.5-5.3 mmol/L). Computerized tomography (CT) of the
abdomen revealed a tumor of the left adrenal gland and enlargement of the right adrenal gland with normal structure of the pancreas. During hospitalization, the patient had blood while coughing and
CT scan of the lungs showed a tumor 48x38x51 mm in size localized in the laterobasal segment of the left lung with mediastinal lymphadenopathy. He also had bilateral pleural effusions with signs
of pulmonary embolism, which explained elevated troponin values. Biopsy confirmed microcellular lung carcinoma and tumor cells were diffusely positive for TT F-1 and focally for CK7, expressing
markers of neuroendocrine differentiation (chromogranin +++, synaptophysin +++, NS E ++). Since neuroendocrine tumor was confirmed and the patient had low potassium and high glucose, hypercortisolism was suspected. High morning cortisol (1784 mmol/L, normal range 171-536) and unsuppressed ACTH (214 pg/L, <60), as well as a high level of chromogranin (1339 μg/L, <65) were determined. During hospital stay, the patient developed heart and respiratory failure and died in the second week of hospitalization.

Ključne riječi

Small cell lung carcinoma; Adrenocorticotropic hormone; Hyperamylasemia; Case reports

Hrčak ID:

156232

URI

https://hrcak.srce.hr/156232

Datum izdavanja:

1.12.2015.

Podaci na drugim jezicima: hrvatski

Posjeta: 2.303 *