How can lung cancer cause hyper pigmentation?

There are two cases in which a lung cancer can lead to hyper pigmentation in skin:

1. Metastasis:

• Adrenals are the most common site of metastasis for a lung cancer
• Lung cancer metastasizes to the adrenals
• Destroyed adrenal cortex
• Decreases cortical hormones
• Decreased cortisol in turn increased hypothalamic CRH production (Negative feedback)
• That leads to increased pituitary proopiomelanocortin (POMC) production and breakdown
• Breakdown of POMC yields beta MSH, beta endorphin and ACTH
• MSH (little) and ACTH (mainly) increase melanin content of the skin
• Increased melanin in skin leads to hyper pigmentation

This case is more like Addisons because adrenal cortex is destroyed by malignancy.

2. Ectopic ACTH
It can produce hyperpigmentation rarely because

• The disease course is not long enough
• ACTH structure may differ from that produced in pituitary as POMC is produced only in pituitary including specific amino acids in pituitary ACTH that are necessary for their action in skin receptors

This case is more like Cushings because the adrenal cortical hormones increase due to ectopic ACTH.

By Doctor

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From team AIMCites

What is the differential diagnosis for Zollinger-Ellison Syndrome?

About 30% of the cases suffering from Zollinger-Ellison syndrome also suffer from MEN1 (Multiple Endocrine Neoplasia 1) disease. Following conditions may be kept in mind while diagnosing ZE syndrome:

1. Elevated serum gastrin
2. Achlorhydria
3. Chronic renal failure
4. Drug-induced (usually omeprazole)
5. Duodenal and jejunal ulcers
6. Pernicious anemia
7. Vagotomy
8. Atrophic gastritis
9. Helicobacter pylori infection
10. Gastric obstruction
11. Gastrinoma
12. Recurrent or refractory ulcer disease
13. Gastric hypertrophy and ulcers
14. Pituitary disease
15. Ulcers and diarrhea
16. Hypercalcemia and ulcers
17. Gastric cancer
18. MEN1 syndrome
19. Kidney stones

 By Doctor

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'Doctor writes to increase the basic and clinical knowledge of AIMCites. We recommend you read each and every post from Doctor. You may make notes too.'

From team AIMCites

How can we prevent oral cancers?

Floor of the mouth and vermillion border of the lips are the common sites of oral cancers. Oral carcinoma can be avoided by taking following measures:

Avoid radiations from sun.

Say good bye to tobacco.

Don't use even the smokeless tobacco.

Don't eat betel nut.
Be away from alcohol.
Take a balanced diet with adequate amount of fruits and vegetables that have essential vitamins.

Oral exam once a year to detect the tumor in early stages. Only 33% of the cases detected in the last stages of cancer live for five years.
Adequate and early treatment is necessary for survival.

 By Doctor

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'Doctor writes to increase the basic and clinical knowledge of AIMCites. We recommend you read each and every post from Doctor. You may make notes too.'

From team AIMCites