Swollen Limbs and Bone Pain: A Case Report

Malta medical journal

Joseph M Cacciottolo¹  David Sammut¹  Miguel Debono¹ 

关键词: ACTH syndrome;    ectopic;    carcinoma;    small cell;    case report cushing's syndrome;    hypokalaemia;    lung neoplasms;    osteomalacia;    paraneoplastic syndromes;   

DOI  :  

学科分类：医学（综合）

来源: University of Malta * Medical School

【 摘 要 】

A 50 year old man presented with peripheral oedema, abdominal distension and a pulmonary opacity on CXR. He subsequently perforated his sigmoid colon as a complication of diverticulitis with pericolic abscess. After colectomy his postoperative period was marked by severe hypokalaemia, metabolic alkalosis, hyperglycaemia and recurrent chest infections. Paraneoplastic Cushing`s syndrome was diagnosed after finding elevated serum cortisol and ACTH levels. CT-guided biopsy of the lung lesion revealed small-cell carcinoma. Bone scan disclosed collapse of numerous thoracic vertebrae possibly due to osteoporosis or oncogenic osteomalacia. Treatment with steroid-synthesis blockers was commenced but the patient died before tumour-directed therapy could be started. Ectopic ACTH syndrome and oncogenic osteomalacia are discussed.

【 授权许可】

Unknown