Korean J Nephrol.  2010 Sep;29(5):606-610.

Ectopic ACTH Syndrome and Severe Hypokalemia Associated with Suspicious Pancreatic Malignancy: A Case Report

• Hwang JH
• Han SS
• Cho EJ
• Kim DK
• Oh KH
• Joo KW
• Kim YS
• Han JS
• Kim S
• Ahn C

Abstract

A 72-year-old woman had a 1-month history of general weakness. Previously, after rectal cancer was treated with a low anterior resection, 12 cycles of adjuvant chemotherapy with 5-fluorouracil plus leucovorin was undergone. Follow-up examination showed no evidence of recurrence. However, she suffered from general weakness attributable to hypokalemia, which was refractory to potassium replacement therapy. After further work-up of the hypokalemia, Cushing's syndrome and ectopic adrenocorticotropic hormone (ACTH) syndrome were diagnosed from the laboratory findings that included a markedly elevated level of 24-hour urine-free cortisol. Several imaging studies revealed masses of the pancreas and other organs, which was more likely to be pancreatic cancer. This case is interesting in that cancerous lesions were identified during work-up of hypokalemia.

Keyword

Hypokalemia; Ectopic ACTH syndrome; Pancreatic neoplasms

MeSH Terms

ACTH Syndrome, Ectopic
Adrenocorticotropic Hormone
Aged
Chemotherapy, Adjuvant
Cushing Syndrome
Female
Fluorouracil
Follow-Up Studies
Humans
Hydrocortisone
Hypokalemia
Leucovorin
Pancreas
Pancreatic Neoplasms
Potassium
Rectal Neoplasms
Recurrence
Adrenocorticotropic Hormone
Fluorouracil
Hydrocortisone
Leucovorin
Potassium