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CASE REPORT
Ectopic ACTH-producing large cell neuroendocrine Pancoast tumour presenting as Horner syndrome
  1. Rajanshu Verma1,
  2. Alexandra Lambert2,
  3. Harold H Katz3,
  4. Scott J Benson4
  1. 1Hospitalist, Department of Hospital Medicine, Augusta Health, Fishersville, Virginia, USA
  2. 2Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, USA
  3. 3Department of Endocrinology, Allina Health United Medical Specialties Clinic, St. Paul, Minnesota, USA
  4. 4Department of Family Medicine, Apple Valley Medical Clinic, Apple Valley, Minnesota, USA
  1. Correspondence to Rajanshu Verma; rajanshu{at}gmail.com

Summary

We present an interesting case where a patient is presented with a droopy left eyelid (as part of Horner syndrome) and Cushingoid features which were a result of a Pancoast tumour (apical lung tumour in superior pulmonary sulcus) involving the left lung. This tumour was secreting ectopic adrenocorticotropic hormone (ACTH), a paraneoplastic endocrine phenomenon, which resulted in Cushing syndrome symptomatology. Though most ectopic ACTH-producing lung cancers are either small cell or carcinoid tumours, this was in fact a large cell neuroendocrine cancer (LCNEC). Patient underwent surgical resection and adjuvant/neoadjuvant chemotherapy with radiation; however, he succumbed to LCNEC given aggressive nature of the disease.

https://doi.org/10.1136/bcr-2016-219156

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    Footnotes

    • Contributors AL contributed in manuscript writing, editing, proof reading and final approval of the manuscript. HHK took care of the patient, contributed in manuscript writing and approved the final manuscript. SB took care of patient, contributed to manuscript writing, providing clinical details and approved final manuscript. RV took care of the patient, wrote manuscript, edited, proofread and approved the final version.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.