ECE2023 Eposter Presentations Pituitary and Neuroendocrinology (234 abstracts)
A case of ectopic ACTH syndrome in squamous cell lung cancer
Hatice Sebile Dökmetaş 1 , Ayşenur Akkoyun 2 , Esma Eren 2 , Onur Şahin 2 , Meriç Dökmetaş 2 , Hikmet zeynep Ağaoğlu 2 & Oğuz Kaan Türk 2
1Istanbul Medipol University, Endocrinology, Istanbul, Turkey; 2Istanbul Medipol University, Internal Medicine, Istanbul, Turkey
Cushing’s syndrome as a result of ectopic adrenocorticotropic hormone (ACTH) secretion, is associated with various tumors. Lung squamous cell carcinoma (LUSC) causing ectopic ACTH syndrome is a very rare condition. A 70-year-old male patient with a history of LUSC was admitted to our clinic for evaluation of worsening delirium and hypokalemia. Two courses of pembrolizumab were administered to our patient who was diagnosed with LUSC a month ago. At presentation, neurological examination revealed disorientation, agitation and visual hallucinations. There were no signs of a Cushingoid appearance. Laboratory assessment showed a serum potassium of 2.8 mmol/l (3.1-5.5), glucose of 120 mg/dl (70-100), basal plasma cortisol of 39,3 µg/dl (6-18), ACTH 92,1 pg/mL (7,2-63,3) and post-1 mg dexamethasone serum cortisol 40,9 µg/dl. A high dose dexamethasone (8 mg) suppression test did not result in suppression of the cortisol levels (64,8µg/dl). Brain MRI was taken and no abnormality was detected in the pituitary gland. The patient’s adrenal glands were evaluated as normal in the abdominal imaging. According to the results, the patient was diagnosed with ectopic ACTH syndrome. Metyrapone treatment was started to block cortisol secretion.
Keywords: Ectopic ACTH syndrome, squamous cell lung cancer, delirium
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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