Oat cell carcinoma with hypercortisolemia presenting to a psychiatric hospital as a suicide attempt.

Abstract

This is the first reported case of an ectopic adrenocorticotrophic hormone (ACTH)-producing tumor which manifested itself initially to a psychiatric hospital as a suicide attempt. The patient, a 54-year-old female, had a history of some typical depressive symptoms along with several atypical complaints, but had no classical features of Cushing's disease. She suddenly attempted suicide and was referred to a psychiatric hospital where the diagnosis of Cushing's syndrome was made. Her adrenals were removed and she improved, but later died of metastatic carcinoma of the lung. She is presented as an example of a depressive illness resulting from an endocrinopathy, with emphasis on the diagnostic and therapeutic problems of this class of depression. Suggestions are made for the workup of depressive disorders thought to be due to endocrine disease.