28th February 2025

A 55-year-old man presents with new abdominal striae, weight gain around his abdomen

A 55-year-old man presents with new abdominal striae, weight gain around his abdomen, and difficulty walking up the stairs. He has had a dry cough for over a month. His blood pressure is on average 165/100 on three readings. He is not on any regular medication. He works as an administrator in an office, drinks a bottle of wine each week and has smoked 15 cigarettes a day for the past 30 years.

On examination you notice he has hyperpigmentation, central obesity and wasting of his quadriceps and upper limb muscles. He has reduced breath sounds in the right upper lobe with dullness on percussion. He has no focal neurology and GCS is 15.

A chest X-ray demonstrates a large right-sided lung mass. The GP is concerned this patient has Cushing syndrome secondary to a new lung cancer.

Which of the following correctly identifies the most likely subtype of lung cancer to cause this presentation and the appropriate findings in the workup of Cushing’s syndrome?

Select the SINGLE most appropriate option from the list below. Select ONE option only.