Acute Liver Failure Due to Severe Hepatic Metastasis of Small-cell Lung Cancer Producing Adrenocorticotropic Hormone Complicating Ectopic Cushing Syndrome

Sonoko Kamijo; Satoru Hasuike; Kenichi Nakamura; Yuuka Takaishi; Yuri Yamada; Yoshinori Ozono; Mai Tsuchimochi; Mitsue Sueta; Kazunori Kusumoto; Hisayoshi Iwakiri; Mayumi Akaki; Hiroyuki Tanaka; Hiroaki Kataoka; Kazuya Shimoda; Kenji Nagata

doi:10.2169/internalmedicine.1976-18

CASE REPORTS

Acute Liver Failure Due to Severe Hepatic Metastasis of Small-cell Lung Cancer Producing Adrenocorticotropic Hormone Complicating Ectopic Cushing Syndrome

Sonoko Kamijo, Satoru Hasuike, Kenichi Nakamura, Yuuka Takaishi, Yuri Yamada, Yoshinori Ozono, Mai Tsuchimochi, Mitsue Sueta, Kazunori Kusumoto, Hisayoshi Iwakiri, Mayumi Akaki, Hiroyuki Tanaka, Hiroaki Kataoka, Kazuya Shimoda, Kenji Nagata

Author information

Sonoko Kamijo
Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, Japan
Satoru Hasuike
Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, Japan
Kenichi Nakamura
Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, Japan
Yuuka Takaishi
Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, Japan
Yuri Yamada
Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, Japan
Yoshinori Ozono
Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, Japan
Mai Tsuchimochi
Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, Japan
Mitsue Sueta
Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, Japan
Kazunori Kusumoto
Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, Japan
Hisayoshi Iwakiri
Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, Japan
Mayumi Akaki
Section of Oncopathology and Regenerative Biology, Faculty of Medicine, University of Miyazaki, Japan
Hiroyuki Tanaka
Section of Oncopathology and Regenerative Biology, Faculty of Medicine, University of Miyazaki, Japan
Hiroaki Kataoka
Section of Oncopathology and Regenerative Biology, Faculty of Medicine, University of Miyazaki, Japan
Kazuya Shimoda
Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, Japan
Kenji Nagata
Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, Japan

Keywords: liver failure, small-cell lung cancer, ACTH-producing tumor, ectopic Cushing syndrome

JOURNAL OPEN ACCESS

2019 Volume 58 Issue 20 Pages 2977-2982

DOI https://doi.org/10.2169/internalmedicine.1976-18

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Abstract

A 72-year-old man was admitted to a general hospital with progressive liver dysfunction, hypokalemia, hyperglycemia, and nodules in the lung and liver and then transferred to our institution on the seventh hospital day. Plasma levels of adrenocorticotropic hormone (ACTH), cortisol, and neuron-specific enolase concentrations were extremely high. He developed acute liver failure, his consciousness and general condition deteriorated rapidly, and he died on Day 11. At the postmortem examination, he was found to have extensive metastases from small-cell lung cancer, including advanced hepatic metastases. This is the first reported case of acute liver failure caused by metastases derived from an ACTH-producing pulmonary small-cell carcinoma.

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