Swollen Limbs and Bone Pain: A Case Report

[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.

[学科分类] 医学（综合）

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