Metastatic small cell carcinoma of the lung presenting as pituitary apoplexy and Cushing's syndrome

Vijay Chandra, Larry W. McDonald, Robert J. Anderson

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

We describe a woman with metastatic small cell carcinoma of the lung who presented with pituitary apoplexy and hyperprolactinemia. Within seventeen months she developed florid Cushing's syndrome with anasarca, hyperpigmentation, hypertension with marked hypercortisolemia (not suppressible with 8 mg dexamethasone), elevated serum ACTH, hypokalemic metabolic alkalosis, and multiple hepatic metastases. This picture suggested the presence of ectopic ACTH syndrome. She died 26 months after the episode of pituitary apoplexy. Primary small cell carcinoma of the lung was diagnosed post-mortem. Metastases were present in the left lung, regional lymph nodes, heart, liver, bone marrow, sphenoid bone, anterior pituitary and pituitary capsule. Posterior pituitary was normal. There was no evidence of pituitary hyperplasia, of adenoma or of primary pituitary carcinoma. The results suggest the presence of a primary ACTH-producing small cell carcinoma of the lung that metastasized to the parasellar sphenoid bone and then extended to the anterior pituitary and dura to mimic a primary intrasellar cause of pituitary apoplexy and Cushing's syndrome. The case demonstrates how difficult it may be to diagnose the etiology of Cushing's syndrome and it emphasizes a unique variation in the presentation of small cell carcinoma of the lung.

Original languageEnglish
Pages (from-to)59-66
Number of pages8
JournalJournal of Neuro-Oncology
Volume2
Issue number1
DOIs
StatePublished - Mar 1984
Externally publishedYes

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Pituitary Apoplexy
Pituitary ACTH Hypersecretion
Small Cell Lung Carcinoma
Sphenoid Bone
Cushing Syndrome
Pituitary Neoplasms
Adrenocorticotropic Hormone
Ectopic ACTH Syndrome
Neoplasm Metastasis
Alkalosis
Hyperpigmentation
Hyperprolactinemia
Liver
Dexamethasone
Capsules
Hyperplasia
Edema
Lymph Nodes
Bone Marrow
Hypertension

All Science Journal Classification (ASJC) codes

  • Neuroscience(all)
  • Oncology
  • Clinical Neurology
  • Cancer Research

Cite this

Metastatic small cell carcinoma of the lung presenting as pituitary apoplexy and Cushing's syndrome. / Chandra, Vijay; McDonald, Larry W.; Anderson, Robert J.

In: Journal of Neuro-Oncology, Vol. 2, No. 1, 03.1984, p. 59-66.

Research output: Contribution to journalArticle

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