Kamijo Sonoko, Hasuike Satoru, Nakamura Kenichi, Takaishi Yuuka, Yamada Yuri, Ozono Yoshinori, Tsuchimochi Mai, Sueta Mitsue, Kusumoto Kazunori, Iwakiri Hisayoshi, Akaki Mayumi, Tanaka Hiroyuki, Kataoka Hiroaki, Shimoda Kazuya, Nagata Kenji
Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, Japan.
Section of Oncopathology and Regenerative Biology, Faculty of Medicine, University of Miyazaki, Japan.
Intern Med. 2019 Oct 15;58(20):2977-2982. doi: 10.2169/internalmedicine.1976-18. Epub 2019 Jun 27.
A 72-year-old man was admitted to a general hospital with progressive liver dysfunction, hypokalemia, hyperglycemia, and nodules in the lung and liver and then transferred to our institution on the seventh hospital day. Plasma levels of adrenocorticotropic hormone (ACTH), cortisol, and neuron-specific enolase concentrations were extremely high. He developed acute liver failure, his consciousness and general condition deteriorated rapidly, and he died on Day 11. At the postmortem examination, he was found to have extensive metastases from small-cell lung cancer, including advanced hepatic metastases. This is the first reported case of acute liver failure caused by metastases derived from an ACTH-producing pulmonary small-cell carcinoma.
一名72岁男性因进行性肝功能不全、低钾血症、高血糖以及肺和肝脏结节入住一家综合医院，于住院第7天转至我院。促肾上腺皮质激素（ACTH）、皮质醇的血浆水平以及神经元特异性烯醇化酶浓度极高。他发生了急性肝衰竭，意识和一般状况迅速恶化，并于第11天死亡。尸检发现，他存在小细胞肺癌的广泛转移，包括晚期肝转移。这是首例由产生ACTH的肺小细胞癌转移引起急性肝衰竭的报道病例。
