Gastric adenocarcinoma associated with lymphangitis carcinomatosa, adrenal metastasis with ectopic ACTH syndrome and malignant common bile duct stricture

Arab Journal of Gastroenterology : the Official Publication of the Pan-Arab Association of Gastroenterology
Pradipta GuhaSanjoy Kumar Chatterjee

Abstract

Ectopic adrenocorticotrophic hormone (ACTH) syndrome (EAS) commonly occurs secondary to neuroendocrine tumours and small cell carcinoma of lung. EAS has also been reported in association with gastric carcinoids. But, the occurrence of EAS secondary to gastric adenocarcinoma has rarely been reported. A 45-year-old male patient from Bangladesh presented with abdominal pain, jaundice and hyperpigmentation. Extensive work-up revealed poorly differentiating mucin-secreting adenocarcinoma of stomach with lymphangitis carcinomatosa of lung, bilateral adrenal metastasis and malignant common bile duct (CBD) stricture. Laboratory reports were suggestive for ectopic ACTH production. Most of these features are very rare in adenocarcinoma of stomach, and all these rare events occurring in a single patient is probably the rarest.

References

Feb 1, 1994·Clinical Endocrinology·P M StewartA White
Aug 26, 1998·Journal of Clinical Gastroenterology·K M ChuJ Wong
May 29, 2001·Journal of Clinical Pathology·C J StewartW R Murray

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