Journal Information
Vol. 25. Issue 6.
Pages 243-245 (August - September 1989)
Share
Share
Download PDF
More article options
Vol. 25. Issue 6.
Pages 243-245 (August - September 1989)
Full text access
Hiperpigmentacion cutanea por secrecion ectopica de ACTH debida a un tumor carcinoide bronquial
Hyperpigmentation of the skin induced by ectopic ACTH secretion in carcinoid bronchial tumor
Visits
7154
J. Freixinet, M. Mateu, J. Sánchez-Lloret
Servicio de Cirugía Torácica. Unidad de Cirugía Torácica y Cardiovascular. Hospital Clínico y Provincial. Facultad de Medicina. Barcelona
M.D. Rodríguez Vaca*
* Departamento de Endocrinología y Diabetes. Hospital Clínico y Provincial. Facultad de Medicina. Barcelona
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics

Se presenta el caso de un varón de 26 años de edad, que en marzo de 1977 inició un cuadro sugestivo de síndrome de Cushing que fue tratado en otro centro hospitalario mediante suprarrenalectomía bilateral y tratamiento sustitutivo. Unos meses después inició una hiperpigmentación cutáneo-mucosa progresiva, con cifras de ACTH en sangre entre 149 y 4000 pq/ml.

En abril de 1985 consultó a nuestro servicio por toracalgia izquierda, detectándose en la radiología de tórax una masa en campo pulmonar superior izquierdo. El resto de estudios diagnósticos no aportaron más datos de interés y fue intervenido en junio de 1985 hallando una tumoración en lóbulo superior izquierdo, cuyo diagnóstico definitivo fue de tumor carcinoide bronquial secretor de ACTH.

En el curso postoperatorio se objetivó una despigmentación progresiva hasta lograr una coloración de piel normal. Las cifras de ACTH disminuyeron hasta la normalidad y por el momento no hay evidencia de recurrencia de la enfermedad ni de diseminación de la misma.

A 26-year-old male developed clinical features suggesting Cushing's syndrome in March 1977. He was treated in another hospital with bilateral adrenalectomy and substitution therapy. A few months later he developed progressive cutaneous and mucosal hiperpigmentation, with blood ACTH levels between 149 and 4000 pg/ml.

In April 1985 he consulted in our Service for left thoracic pain. In the chest radiogram a mass in upper left lung was apparent. The remaining diagnostic studies did not disclose any more relevant data. The patient was operated in June 1985 and a tumor was found in left upper lobe. The definitive diagnosis was bronchial ACTH secreting carcinoid tumor.

During the postoperative period a proggressive reduction in pigmentation was observed until the skin color returned to normal. The ACTH levels also came down to normal. Until the present time there is no evidence of recurrence or dissemination of the disease.

Full text is only aviable in PDF
Bibliografia
[1.]
W.H. Brown.
A case of pluriglandular syndrome.
«Diabetes of bearded woman». Lancet, 2 (1928), pp. 1022-1023
[2.]
H. Imura, S. Matsukura, H. Yamamoto.
Studies on ectopic ACTH-producing tumors. Clinical and biochemical features of 30 cases.
Cancer, 35 (1975), pp. 1430-1434
[3.]
P.J. Lowry, I.H. Rees, S. Tomlin, G. Gillies, J. Landon.
Characterization of ectopic ACTH purified from a malignant thymic carcinoid tumor.
J Clin Endocrinol Metab, 43 (1976), pp. 831-833
[4.]
J.C. Birkenhäger, E.V. Upton, H.J. Seldenrath, D.T. Krieger, A.H. Tashjian.
Medullary thyroid carcinoma: ectopic production of peptides with ACTH-like corticotrophins releasing factor-like and prolactin production-stimulating activities.
Acta Endocrinol, 83 (1976), pp. 280-283
[5.]
D.N. Orth, R. Guillemin, N. Ling, W.E. Nicholson.
Immunoreactive endorphins, lipotrophins and corticotrophins in a human non pituitary tumor: evidence for a common precursor.
J Clin Endocrinol Metab, 46 (1978), pp. 849-853
[6.]
Y. Kato, T.B. Ferguson, D.E. Bennett, T.H. Burford.
Oat cell carcinoma of the lung. A review of 138 cases.
Cancer, 23 (1969), pp. 517-521
[7.]
W.I. Morse, N. Kerenyi, D.H. Nelson.
Prolonged hyperadrenal corticotrophinism and pygmentation associated with bronchial carcinoid tumor. A case report.
Can Med Assoc J, 96 (1967), pp. 104-109
[8.]
R. Timothy, J. Lieske, J. Kinkaid, E.V. Sunderrajan.
Thymic carcinoid with cutaneous hyperpigmentation.
Arch Intern Med, 145 (1985), pp. 361-363
[9.]
S. Attar, J.E. Miller, J. Hankins, B.W. Thompson, C.M. Suter, P.J. Kleger, J.S. McLaughlin.
Bronchial adenoma: a review of 51 patients.
Ann Thorac Surg, 40 (1985), pp. 126-132
[10.]
D.G. Van Sickle.
Carcinoid tumors: analysis of 61 cases including 11 cases of carcinoid syndrome.
Cleve Clin Q, 39 (1972), pp. 79-85
[11.]
L.J. Deftos, P.J. McMillen, G.P. Sartiano, J. Abnid.
Robinson Ag. Simultaneous ectopic production of parathyroid hormone and calcitonin.
Metabolism, 25 (1976), pp. 543-545
[12.]
J.M. Shames, N.R. Dhuramdhar, W.E. Blackard.
Insulin-secre-ting bronchial carcinoid tumor with widespread metastases.
Am J Med, 44 (1968), pp. 632-634
[13.]
S.A. Leveston, D.W. McKeel, P.J. Buckley, K. Deschryver, M.H. Greider, B.M. Jaffe, W.M. Danghaday.
Acromegaly and Cushing's syndrome associated with a foregut carcinoid tumor.
J Clin Endocrinol Metabolism, 53 (1986), pp. 682-685
[14.]
B.L. Pimstone, C.J. Vys, L. Volgepoel.
Studies in a case of Cushing's syndrome due to an ACTH-producing thymic tumor.
Am J Med, 53 (1972), pp. 521-525
Copyright © 1989. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?