Woman with advanced lung cancer, thin skin diagnosed with Cushing’s
Thin skin is a sign of hypercortisolism that’s linked to decreased collagen
A woman in Switzerland with metastatic lung cancer who developed thin skin and was later diagnosed with Cushing’s syndrome was the subject of a repoort by researchers.
Metastatic cancer occurs when the disease has spread from its original site to other parts of the body. In this case, Cushing’s was presumed to be associated with the woman’s underlying cancer. Her case was described in the study, “Thin Skin in Cushing’s Syndrome,” in The New England Journal of Medicine.
Cushing’s syndrome encompasses several health conditions that feature chronically elevated levels of the hormone cortisol, or hypercortisolism. Cushing’s disease, one of its most common forms, is caused by tumors in the brain’s pituitary gland that trigger the excessive production of adrenocorticotropic hormone (ACTH), which stimulates cortisol production. Less frequently, Cushing’s is caused by ACTH-producing tumors in other parts of the body. This is known as ectopic Cushing’s syndrome.
Cushing’s syndrome associated with cancer
Here, researchers presented the case of a woman, 53 with a history of metastatic small cell lung cancer, a type of lung cancer, who was admitted to the hospital with signs of Cushing’s syndrome. These included high blood pressure, high blood sugar, low potassium levels, called hypokalemia, and metabolic alkalosis, which his a buildup of alkaline substances in blood and body fluids.
During a physical exam, the woman was found to have thin skin, with the skin on the back of her third finger measuring 1.2 mm in thickness. A normal value is above 1.8 mm. Skin thickness is commonly measured on the back of the fingers to avoid the interference of underlying fat, which can affect measurements in other parts of the body.
Thin skin is a clinical sign of hypercortisolism that’s associated with decreased collagen production. Collagen is a protein that provides structural support and strength to the skin and other tissues, and its production is inhibited by excess glucocorticoids, such as cortisol.
The woman’s blood and urine cortisol levels were also elevated, as were her blood ACTH levels. An MRI scan didn’t reveal a pituitary tumor, but new cancer lesions were found in her lungs, bones, liver, and meninges, the membranes that cover and protect the brain and spinal cord.
The woman was diagnosed with Cushing’s syndrome, presumed to be associated with her underlying cancer. After discussing her prognosis with her physicians, she opted for palliative care and died a week later.
About the Author
