Small cell lung cancer with panhypopituitarism due to ectopic adrenocorticotropic hormone syndrome: A case report

Table 1 Hormone levels and biochemical indexes detected before and after chemotherapy

Biochemical assay	Normal range	Prior to chemotherapy	After 1stround	After 2ndround	After 3rdround
8 am ACTH	10–80 ng/L	210	127	74	45
4 pm ACTH	5–40 ng/L	192	100	43	21
8 am cortisol	8.7–22.4 μg/dL	31.17	16.79	8.8	8.64
4 pm cortisol	0–10 μg/dL	35.18	11.26	2.36	2.47
0 am cortisol	0–5 μg/dL	31.27	14.47	1.75	3.64
24 h urine cortisol		> 1932.8	341.6	154.4	120.5
FPG (mmol/L)		5.6	4	5.8	5.4
2 h PPG (mmol/L)		13	7.9	6.9	6.8
Testosterone	1.75–7.81 μg/L	0.98	0.94	3.57	4.01
FSH	1.27–19.26 IU/L	5.58	5.09	12.79	16.68
LH	1.24–8.62 IU/L	4.18	2.02	6.08	5.42
TSH	0.35–4.94 mIU/L	0.07	1.36	1.46	0.94
TT4	4.87–11.72 μg/dL	4.19	4.41	7.83	6.15
TT3	0.58–1.59 ng/mL	0.43	0.56	1.31	1.19
FT4	0.7–1.48 ng/dL	0.94	0.83	1.17	0.84
FT3	1.71–3.71 pg/mL	1.4	1.63	3.7	2.82
24 h urine volume (mL/d)		3200	2800	2400	1170
Urine specific gravity	1.015–1.025	1.010	1.014	1.016	1.020
NSE	0–15.2 ng/mL	18.27	9.59	10.39	-
CEA	0–5 ng/mL	7.35	2.91	2.69	-

ACTH: Adrenocorticotropic hormone; FPG: Fasting plasma glucose; PPG: Postprandial plasma glucose; FSH: Follicle-stimulating hormone; LH: Luteinizing hormone; TSH: Thyroid stimulating hormone; TT₄: Total thyroxine; TT₃: Total tri-iodothyronine; FT₃: Free tri-iodothyronine; FT₄: Free thyroxine; NSE: Neuron-specific enolase; CEA: Carcinoembryonic antigen.

Table 2 Water deprivation and vasopressin test data

Time	Urine volume (mL)	Urine specific gravity	Plasma osmotic pressure (osmo/kg)	Weight (kg)	Blood pressure (mmHg)	Heart rate (bpm)	Notes
1st day 22:00	250	1.010	298	51.0	136/75	73	Start water deprivation
2nd day 11:50	100	1.012	305	48.5	131/77	81	Platform stage pituitrin administration
2nd day 12:50	100	1.018	-	49.0	103/74	75	-
2nd day 13:50	50	1.018	301	49.0	121/76	76	Off-test