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A Case of Persistent Hypokalaemia Leading to a Diagnosis of Carcinoid Lung Cancer with Positive Markers for Both Cushings and Carcinoid Syndrome

 Case Report

Volume 3, Issue 9 (September Issue) 

A Case of Persistent Hypokalaemia Leading to a Diagnosis of Carcinoid Lung Cancer with Positive Markers for Both Cushings and Carcinoid Syndrome

Benjamin Woolner1* and Ali Naqvi2

1Salisbury NHS Foundation Trust, United Kingdom

2Isle of Wight NHS Trust, United Kingdom

*Corresponding author: Benjamin Woolner, Salisbury NHS Foundation Trust, United Kingdom. E-mail: benjamin.woolner1@nhs.net

Received: October 28, 2021; Accepted: November 04, 2021; Published: November 15, 2021

Citation: Woolner B, Naqvi A, et al. A Case of Persistent Hypokalaemia Leading to a Diagnosis of Carcinoid Lung Cancer with Positive Markers for Both Cushing’s and Carcinoid Syndrome. Clin Image Case Rep J. 2021; 3(9): 190.

https://www.literaturepublishers.org

Abstract

An 81-years-old gentleman presented with a 2-week history of reduced appetite, lethargy and 2-3 kg weight loss over the previous one month. Routine investigations identified a potassium of 2.2 mmol/L. He was admitted for IV potassium replacement. His repeat potassium level after 3 days, was less than 2.9 mmol/L. His admission chest radiograph showed a suspicious lung lesion. A CT chest was arranged and revealed a left lower lobe lesion, consistent with a new malignancy, suspicious of a small cell lung cancer. Further biochemical and hormonal assays increased suspicions of an ACTH secreting carcinoid tumour. A PET scan, identified increased uptake of FDG in the lung lesion. Tumour histology was positive for ACTH, synaptophysin, chromogranin A and CD56 secretion. Proliferation index assessed with Ki67 was less than 1%. Chromogranin A was elevated, and Urine 5-HIAA testing was positive. A 24-hour free cortisol excretion test was elevated at 213 mmol/L. He was not a surgical candidate. Subsequently, he functionally deteriorated and was referred to the palliative team.

Keywords: Hypokalaemia; Carcinoid lung cancer; Cushing’s syndrome; Carcinoid syndrome

https://www.literaturepublishers.org/archive/A-Case-of-Persistent-Hypokalaemia-Leading-to-a-Diagnosis-of-Carcinoid-Lung-Cancer-with-Positive-Markers-for-Both-Cushings-and-Carcinoid-Syndrome.html

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