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Cases J. 2009 Jul 31;2:6174. doi: 10.4076/1757-1626-2-6174.

Severe hypokalemia, metabolic alkalosis and hypertension in a 54 year old male with ectopic ACTH syndrome: a case report.

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Departamento de Medicina Interna, Hospital Regional, Dr. Valentín Gómez Farías Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado. Av. Soledad Orozco 203, Col. EL Capullo, Zapopan, 45150, Jalisco Mexico.


Ectopic ACTH syndrome is a rare cause of Cushing's syndrome accounting for about 15% of all cases. Small cell lung cancer and bronchial carcinoids account for about half of the cases. Malignant neoplasm has rapid and more aggressive metabolic effects. We report a 54-year-old male patient with phenotypic features of Cushing's syndrome with severe hypokalemia, metabolic alkalosis, hypertension and altered mental status as manifestations of an ACTH-secreting small cell carcinoma from the lung. Ectopic ACTH syndrome should be highly considered in patients with hypertension and severe hypokalemic metabolic alkalosis, especially when a lung mass is discovered.

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