Malik Jawad, Arshad Laraib
Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester, GBR.
Cureus. 2025 Jul 20;17(7):e88382. doi: 10.7759/cureus.88382. eCollection 2025 Jul.
We present a case of a middle-aged woman who presented with chest pain and shortness of breath. Laboratory tests revealed persistent hypokalaemia, hyperglycaemia, and metabolic alkalosis despite treatment. Imaging identified a mass near the right hilum suggestive of lung malignancy. Endocrine evaluation showed markedly elevated cortisol and adrenocorticotropic hormone levels, consistent with paraneoplastic Cushing syndrome caused by ectopic hormone production. The analysis of the lung biopsy obtained through bronchoscopy confirmed the diagnosis of small cell lung cancer (SCLC). The patient was treated with metyrapone and spironolactone to stabilise her metabolic abnormalities and was subsequently referred for chemotherapy following a multidisciplinary team review. This case highlights the importance of recognising paraneoplastic syndromes as atypical presentations of malignancy and emphasises the role of a coordinated, multidisciplinary approach in diagnosis and management.
我们报告一例中年女性病例，该患者出现胸痛和呼吸急促症状。尽管进行了治疗，但实验室检查显示持续低钾血症、高血糖症和代谢性碱中毒。影像学检查发现右肺门附近有一个肿块，提示为肺恶性肿瘤。内分泌评估显示皮质醇和促肾上腺皮质激素水平显著升高，符合由异位激素产生引起的副肿瘤性库欣综合征。通过支气管镜检查获取的肺活检分析证实为小细胞肺癌（SCLC）。患者接受了甲吡酮和螺内酯治疗以稳定其代谢异常，随后在多学科团队会诊后转诊接受化疗。该病例突出了认识副肿瘤综合征作为恶性肿瘤非典型表现的重要性，并强调了协调的多学科方法在诊断和管理中的作用。
