A case report of ACTH-producting malignant tumor of ovary

Background: We report the fourth case of an ACTHproducing malignant ovarian tumor. Case: A 64-year-old woman suffered from lower abdominal pain, right inguinal pain, and transient extremidial paralysis in May 1999. A colon polypectomy revealed, there hypokalemia, hyperglycemia, hyperthyroidism, and elevated CEA, LDH, cortisol, and ACTH. Hard masses about 3-4cm in diameter were palpable at the bilateral ovaries and a right inguinal tumor was seen. Aspiration biopsy from the right inguinal tumor showed secondary Cushing syndrome caused by the ectopic ACTH-producing malignant tumor. She admitted to the hospital and right inguinal lympharectomy showed a metastatics small-cell carcinoma tumor. She was treated twice with intraarterial chemothrapy using CBDCA, which ameliorated her symptoms and laboratory data became normal. A few months later, a tumor recurred. Second-line chemotherapy and radiation were inffective, and she died. Autopsy suggested a primary ovarian tumor. Conclusion: This is, to owr knowledge, only the fourth case of an ACTH-producing malignant ovarian tumor of ovary reported anywhere. Other cases involved adenocarcinoma, and only this case involved small-cell carcinoma.