2006 Volume 20 Issue 5 Pages 756-759
The patient was a 64-year-old man who had left hemiparesis due to a brain infarction. He had severe hypertension and his serum adrenocorticotropic hormone (ACTH) level was high. A chest roentgenogram and a chest computed tomographic scan revealed a right lung tumor. Histology from a bronchoscopic examination revealed a lung adenocarcinoma (C-T2N0M0 stage IB). A right lower lobectomy with a mediastinal lymph node dissection was performed. Immunohistochemical staining for ACTH was positive in the cancer cells and we diagnosed an ACTH-producing lung adenocarcinoma (p-T2N0M0 stage IB). After the operation, his serum ACTH level decreased and we decreased the antihypertensive drugs. Paraneoplastic syndrome caused by ectopic ACTH production has been reported in association with a variety of malignant tumors. However, most cases involving this syndrome are associated with neuroendocrine tumors such as a small-cell carcinoma or carcinoid of the lung. An ACTH producing lung adenocarcinoma is a rare case. To the best of our knowledge, this is the fifth reported case of an ACTH producing lung adenocarcinoma and the second for which resection had been performed.
