Müssig Karsten, Horger Marius, Häring Hans-Ulrich, Wehrmann Manfred
Lung Cancer. 2007 Jul;57(1):120-2. doi: 10.1016/j.lungcan.2007.03.003. Epub 2007 Apr 5.
Small cell lung carcinoma (SCLC) is frequently associated with a paraneoplastic syndrome.
We report on a rare case of SCLC presenting with syndrome of inappropriate antidiuretic hormone (SIADH) secretion and ectopic ACTH production. In accordance with the endocrine evaluation, immunohistochemical staining of the tumour was positive for ADH and ACTH. Chemotherapy with etoposide and carboplatin induced a nearly complete remission.
Simultaneous secretion of ADH and ACTH is infrequently reported with only five cases described in the literature. SIADH in patients with ectopic ACTH syndrome may be underdiagnosed due to the antagonistic hormone actions of cortisol and ADH on renal sodium excretion.
小细胞肺癌（SCLC）常伴有副肿瘤综合征。
我们报告1例罕见的小细胞肺癌，其表现为抗利尿激素分泌异常综合征（SIADH）及异位促肾上腺皮质激素（ACTH）分泌。根据内分泌评估，肿瘤的免疫组化染色显示抗利尿激素和促肾上腺皮质激素呈阳性。依托泊苷和顺铂化疗诱导病情几乎完全缓解。
抗利尿激素和促肾上腺皮质激素同时分泌的情况鲜有报道，文献中仅描述了5例。由于皮质醇和抗利尿激素对肾钠排泄的拮抗激素作用，异位促肾上腺皮质激素综合征患者的抗利尿激素分泌异常综合征可能未得到充分诊断。
