Long-term Survival of a Patient with Small Cell Lung Cancer Secreting ADH and ACTH Simultaneously, Following the Prolonged Use of Amrubicin

Abstract

Paraneoplastic syndromes are frequently observed in lung cancer, especially in small cell lung cancer (SCLC). Although there have been many reports on paraneoplastic syndromes, few reports have been published on SCLC that simultaneously produces antidiuretic hormone (ADH) and adrenocorticotropic hormone (ACTH), and these reports described the prognosis of such cases as extremely poor. We herein present a rare case of a Japanese woman with SCLC accompanied by syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and Cushing's syndrome. The survival of the patient was prolonged by the long-term administration of amrubicin.

Syndrome of Inappropriate Antidiuretic Hormone Secretion as the Initial Presentation in a Patient with Stage I Small-cell Lung Cancer

“…However, the plasma ADH level (3.4 pg/dL) just before surgery was too low compared with other reports of ectopic ADH-producing SCLC ( 6 , 7 , 13 ). Furthermore, the resected tumor cells were negative for ADH on an immunohistochemical examination.…”

Síndromes paraneoplásicos asociados a cáncer de pulmón

“…Síndrome caracterizado por un estado de hiponatremia hipoosmolar euvolémica que, en el contexto de un cáncer pulmonar, se debe a la producción ectópica de hormona antidiurética (ADH). 15,16 Aproximadamente, 70% de todos los síndromes de secreción inadecuada de la hormona antidiurética (SIADH) de carácter paraneoplásico están asociados a cáncer pulmonar de estirpe de células pequeñas. En 10 y 45% de este tipo de cánceres se presenta una producción ectópica de ADH.…”

Electrolyte Derangements when Ectopic Cushing's Is Included in Dual Paraneoplastic Syndrome

“…Although ectopic adrenocorticotropic hormone (ACTH) syndrome is typically characterized by hypokalemia, which may be refractory to treatment, as in the recently reported case, 1 the occasional patient presents with concurrent hyponatremia, as depicted in several case studies. [2][3][4][5] This biochemical association is attributable to the rarely reported paraneoplastic syndrome of coexistence of ectopic ACTH secretion and syndrome of inappropriate antidiuretic hormone secretion. [2][3][4] The underlying cause was small-cell lung cancer in all 11 fully investigated cases.…”

“…[2][3][4][5] This biochemical association is attributable to the rarely reported paraneoplastic syndrome of coexistence of ectopic ACTH secretion and syndrome of inappropriate antidiuretic hormone secretion. [2][3][4] The underlying cause was small-cell lung cancer in all 11 fully investigated cases. [2][3][4] Among patients with this syndrome (the so-called "dual paraneoplastic syndrome"), plasma ACTH levels have ranged from "high normal" 2 to 851 pg/mL.…”

“…[2][3][4] The underlying cause was small-cell lung cancer in all 11 fully investigated cases. [2][3][4] Among patients with this syndrome (the so-called "dual paraneoplastic syndrome"), plasma ACTH levels have ranged from "high normal" 2 to 851 pg/mL. 4 In the 91-year-old patient who presented with hyponatremia and hypokalemia (the latter easily reversed by administration of triamterene), 5 hyponatremia was initially incorrectly attributed to triggering of inappropriate secretion of antidiuretic hormone by congestive heart failure (because chest radiography showed cardiomegaly and pulmonary congestion).…”