One Case of the Lung Carcinoid with the High Level of Plasma ACTH

Abstract

A fifty year-old male lung carcinoid case with a high level of plasma ACTH was reported. A tumor shadow was found in the left lung field approximately 6 years before by mass survey. He had no complaints, but since the tumor shadow gradually increased in size, he was referred to our Department. Cytologic diagnosis was obtained by percutaneous lung needle biopsy. Plasma ACTH was 350 pg/ml. We found no particular clinical abnormalities of the pituitary gland, thyroid gland, digestive organs. Left upper lobe lobectomy with complete mediastinal lymphnode dissection was performed. The tumor was 4×3×3.5cm with a well-defined margin. The histologic diagnosis was histologic carcinoid. No particular complication occurred postoperatively, but plasma ACTH levels remained high for about 3 months. At 5 months after surgery the plasma ACTH level was normal (60pg/ml). Therefore, we consider that this lung carcinoid produced so-called big-ACTH, nevertheless we could find no manifestation of ectopic ACTH syndrome.