facial hyperpigmentation: any link to cancer?

Introduction: ectopic adrenocorticotropic hormone (acth) syndrome is recognized by edema, proximal muscle weakness, hypertension, diabetes and skin hyperpigmentation. this syndrome is mainly associated with malignancies. case presentation: a 43-year-old woman came to our hospital with a history of new-onset diabetes, hypertension, edema and facial hyperpigmentation from four months before. upon admission, she had alkalosis, hypokalemia, mild hypertension and low-grade fever. due to abdominal pain, an abdominal ultrasound was performed, which revealed common bile duct (cbd) and pancreatic duct dilation. the abdominopelvic computed tomography (ct) scan showed a poorly-enhancing mass in the periampullary region. conclusion: the patient's facial hyperpigmentation and hypokalemia appear to have been due to acth ectopic syndrome as a result of periampullary cancer.