Severe psychosis due to Cushing's syndrome in a patient with a carcinoid tumour in the lung: a case report and review of the current management.

Severe psychosis in patients with Cushing's syndrome is a rare occurrence and can be extremely resistant to medical therapy. We describe a case of a 51-year-old Afro-Caribbean female patient, with refractory severe hypertension (initially resistant to polypharmacy) and gradual development of severe psychosis secondary to ectopic Cushing's syndrome, who was subsequently diagnosed to have a carcinoid tumour in her lung. Her psychotic episodes - secondary to hypercortisolism and initially refractory to the medical therapy - subsided only after the resection of the carcinoid tumour in her right lower pulmonary lobe.

Paraneoplastic effects on neurophthalmologic function.

Objective: Paraneoplastic neurologic syndrome with otoneurophthalmologic manifestations is much less common than direct, metastatic, and treatment-related complications of cancer. Few studies have focused on patients presenting with paraneoplastic syndrome before a cancer is identified.

Patient: We describe a case of combined paraneoplastic brainstem/limbic encephalitis and Lambert-Eaton myasthenic syndrome in a patient with small cell lung cancer and positive antiamphiphysin antibodies who initially presented with otoneurophthalmologic signs and symptoms to the ears, nose, and throat clinic.