Facial hyperpigmentation: Any link to cancer?
Introduction: Ectopic adrenocorticotropic hormone (ACTH) syndrome is recognized by edema, proximal muscle weakness, hypertension, diabetes and skin hyperpigmentation. This syndrome is mainly associated with malignancies. Case presentation: A 43-year-old woman came to our hospital with a history of new-onset diabetes, hypertension, edema and facial hyperpigmentation from four months before. Upon admission, she had alkalosis, hypokalemia, mild hypertension and low-grade fever. Due to abdominal pain, an abdominal ultrasound was performed, which revealed common bile duct (CBD) and pancreatic duct dilation. The abdominopelvic computed tomography (CT) scan showed a poorly-enhancing mass in the periampullary region. Conclusion: The patient's facial hyperpigmentation and hypokalemia appear to have been due to ACTH ectopic syndrome as a result of periampullary cancer.
2. Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J, et al. Disorders of adrenal cortex. Harrison's principles of internal medicine. Mc graw hill; 2015. p. 2309-29.
3. Alexandraki KI, Grossman AB. The ectopic ACTH syndrome. Rev Endocr Metab Disord. 2010;11(2):117-26.
4. Jabbour SA. Skin manifestations of hormone‐secreting tumors. Dermatol Ther. 2010;23(6):643-50.
5. Thiers BH, Sahn RE, Callen JP. Cutaneous manifestations of internal malignancy. CA Cancer J Clin. 2009;59(2):73-98.
6. Asgharian B, Turner ML, Gibril F, Entsuah LK, Serrano J, Jensen RT. Cutaneous tumors in patients with multiple endocrine neoplasm type 1 (MEN1) and gastrinomas: prospective study of frequency and development of criteria with high sensitivity and specificity for MEN1. J Clin Endocrinol Metab. 2004;89(11):5328-36.
7. Saggini A, Brandi M. Skin lesions in hereditary endocrine tumor syndromes. Endocr Pract. 2011;17(Supplement 3):47-57.