Hyperpigmentation, Severe Hypokalemia and Metabolic Alkalosis in a 41-year-old Man with Small Cell Lung Cancer and Ectopic ACTH Syndrome: A Case Report

小細胞肺癌併發異位性ACTH症候群引發色素沉積、重度低血鉀及代謝性鹼血症：病例報告

陳禮揚(Li-Yang Chen) ； 何肇基(Chao-Chi Ho)

《胸腔醫學》 31卷3期 (2016/06) Pp. 156-163

摘要

異位性ACTH 症候群佔所有庫欣氏症候群之百分之十，最容易在小細胞肺癌或各種類癌瘤之患者中發生。與其他原因造成之庫欣氏症候群患者相比，異位性ACTH 症候群較容易表現出色素沉積及礦物性皮質素過量之症狀。本篇文章探討一位四十一歲，新診斷為小細胞肺癌並合併異位性ACTH 症候群的病人，最開始以顯著色素沉積、重度低血鉀及代謝性鹼血症來表現。這些現象皆在開始治療後消失。因此，當病人被發現有肺腫瘤，同時合併有近期內發生之色素沉積，以及這些代謝異常時，可能是因為異位性ACTH 症候群所導致。

關鍵字

異位性ACTH 症候群 ； 庫欣氏症候群 ； 小細胞肺癌 ； 色素沉積

並列摘要

Ectopic ACTH syndrome accounts for 10% of cases of Cushing’s syndrome and is associated mostly with small cell lung cancer or carcinoid tumors. Compared with other forms of Cushing’s syndrome, ectopic ACTH syndrome usually exhibits more mineralocorticoid activity and hyperpigmentation. We reported a 41-year-old man who presented with hyperpigmentation, severe hypokalemia and metabolic alkalosis, and was diagnosed as having small cell lung carcinoma with ectopic ACTH syndrome. After months of treatment for lung cancer, both the pigmented skin and the biochemical profiles had recovered. In patients with lung tumors, a history of recently developed skin pigmentation and biochemical study results showing hypokalemia and metabolic alkalosis imply an ectopic ACTH syndrome.

並列關鍵字

ectopic ACTH syndrome ； Cushing’s syndrome ； small cell lung cancer ； hyperpigmentation