Studies on adrenal cortical function in patients with lung cancer

Abstract

The adrenocortical function of 23 patients with lung cancer was examined by a simplified testing sequence which evaluates 7 different parameters simultaneously. Only 9 patients showed normal values in each test. The other 14 patients were shown to have one or more of the following abnormalities: (1) elevated plasma cortisol levels, (2) abolishment of their diurnal variation, (3) failure of their suppressibility by 1 mg. of dexamethasone, and (4) increased excretion of free cortisol in their urine. Although it is not fully known why abnormal adrenocortical functions were found so frequently among patients with lung cancer, it could be explained by ectopic ACTH production by the malignancy in at least two patients. Furthermore, a rapid change in adrenocortical function seen in one of them might be an initial sign of an ACTH-producing tumor.