Endocrine-metabolic hypertension.
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Small-cell lung cancer may be accompanied by hypercortisolism due to secretion of adrenal stimulating peptides. This occurs almost exclusively in case of extensive disease. The neuroendocrine cell, from which these tumours may originate, plays an important part in the production of these peptides. Four patients are described with small-cell lung cancer and clinical presentation of hypercortisolism, particularly manifesting itself with hypokalaemia.
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An electrolyte-regulating corticoid has been identified and given the name aldosterone. This hormone may be produced in amounts above normal in adrenal cortical tumors in hyperplastic adrenal glands and in normal appearing adrenal glands. Overproduction of aldosterone is accompanied by certain characteristic clinical manifestations which should suggest the diagnosis. The diagnosis may be supported by examinations available in most well equipped clinical laboratories. Bioassay of aldosterone in the urine and estimation of exchangeable body sodium and potassium, using radioactive salts, are necessary for confirmation of the diagnosis.Since the description of this salt-retaining hormone by Simpson and Tait and the discovery of its chemical structure by Reichstein in 1954, reports of 14 cases have been published. Surgical removal of the offending tissue gives spectacular relief from the very distressing symptoms.
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