Oncogenic Cushing's syndrome and nephrotic syndrome in the same patient.

The association of the nephrotic syndrome with malignancy is well established. This case report describes a patient who presented with renal cell carcinoma and went on to develop ectopic adrenocorticotropic hormone (ACTH) syndrome as well as the nephrotic syndrome. The patient's presentation was with hypokalemia refractory to conventional medical therapy. Oncogenic Cushing's syndrome and minimal change disease were diagnosed. We discuss the differentiation of Cushing's disease and Cushing's syndrome as well as oncogenic nephrotic syndrome and therapeutic options.