# Unusual Presentation of Case of a Lung Carcinoid Tumor With Ectopic Adrenocorticotropic Secretion (EAS) Associated With Acute Weight Gain and Peripheral Edema

## TL;DR

A rare case of a lung tumor causing abnormal hormone secretion leading to Cushing's syndrome is presented, highlighting unusual symptoms like rapid weight gain and swelling.

## Contribution

This case report adds to the understanding of ectopic ACTH secretion from non-small-cell lung tumors and its atypical clinical presentation.

## Key findings

- EAS can present with acute weight gain and peripheral edema, not just typical Cushing's features.
- Tumor resection is preferred for managing EAS, with adrenalectomy as an alternative when surgery is not feasible.
- Steroidogenesis inhibitors are used to control cortisol levels before definitive treatment.

## Abstract

Ectopic adrenocorticotropic secretion (EAS) is classically related to small-cell lung cancer but is caused by a wide variety of tumors. In approximately one-fifth of cases, the cause remains unidentified. Excess adrenocorticotropic hormone (ACTH) leads to Cushing’s syndrome, and the presentation can be due to biochemical derangements such as hypokalemia and hyperglycemia. Alternatively, it may manifest with secondary symptoms such as weight gain, hypertension, skin thinning, abdominal striae, and/or psychotic manifestations. The diagnosis is established through dynamic testing after confirming excess cortisol and ACTH levels. Imaging is then used to identify the hormonally active lesion. Controlling hypercortisolism with steroidogenesis inhibitors is the initial step before proceeding to definitive treatment. Ideally, tumor resection, if possible, but bilateral adrenalectomies are considered in cases not amenable to curative surgery.