Literally Malignant Hypertension

Abstract

Ectopic ACTH (adrenocorticotropic hormone) syndrome, EAS, is extremely rare, accounting for only 10–20% of all ACTH-dependent Cushing’s syndromes, and only 5–10% of all types of Cushing’s syndromes. Given the extremely aggressive behavior of malignancies, EAS is typically associated with significantly higher levels of ACTH and cortisol, the difference being 100–1000-fold greater than in Cushing’s disease. Consequently, clinical symptoms and manifestations of EAS can be more severe and rapid in onset. In this case report, we describe the course of EAS-induced malignant hypertension in a 40-year-old patient who was subsequently diagnosed with high-grade poorly differentiated large cell neuroendocrine carcinoma (NEC).