Corticotropin-releasing hormone-producing medullary thyroid carcinoma causing cushing’s syndrome: Clinical and pathological findings
- 64 Downloads
A 62-yr-old woman presented with progressive fatigue and weakness and was found to have hypercalcemia due to a parathyroid adenoma. Following resection of the adenoma, she developed intractable diarrhea with progressive weakness. Further evaluation showed very high serum calcitonin levels and high cortisol and adrenocorticotropic hormone (ACTH) levels along with elevated urinary 5-hydroxindole acetic acid (5-HIAA) levels. Liver biopsy showed metastatic medullary thyroid carcinoma which did not stain positively for ACTH but stained positively for corticotropin-releasing hormone (CRH) and serotonin. Further examination of the parathyroid tissue showed medullary thyroid carcinoma cells invading the adenoma. This is the first report of a patient with hyperparathyroidism and metastatic medullary carcinoma of the thyroid producing serotonin and CRH resulting in Cushing’s syndrome.
Key WordsCRH corticotropin-releasing hormone medullary thyroid carcinoma Cushing’s syndrome Hyperparathyroidism
Unable to display preview. Download preview PDF.
- 9.Fjellestad-Paulsen A, Abrahamson P-A, Bjartell A, Grino M, Grimelius L, Hedeland H, Falmer S. Carcinoma of the prostate with Cushing’s syndrome. A case report with histochemical and chemical demonstration of immunoreactive corticotropin-releasing hormone in plasma and tumoral tissue. Acta Endocrinol 119:506–516, 1988.PubMedGoogle Scholar
- 10.Tournaire J, Rebattu B, Conte-Devlox B, Trouillas J, Grino M, Berger-Dutrieux N, Peix J-L, Pugeat M. Syndrome de Cushing secondaire a la production ectopique de CRF par un carcinoma medullaire du corps thyroide. Ann Endocrinol 49:61, 1988.Google Scholar
- 12.De Herder WW, Krenning EP, Malchoff CD, Hofland LJ, Reubi J-C, Kwekkeboom DJ, Oei HY, Pols HAP, Bruining JA, Nobels FRE, Lamberts SWJ. Somatostatin receptor scintigraphy: its value in tumor localization in patients with Cushing’s syndrome caused by ectopic corticotropin or corticotropin-releasing hormone secretion. Am J Med 96:305–312, 1994.PubMedCrossRefGoogle Scholar
- 15.Roth SI. Principles and Practice of Surgical, Pathology and Cytopathology. 3rd ed., The Parathyroid Gland. In: Silverberg SG, DeLellis RA, Frable WJ, eds. New York: Churchill LIvingstone 1997; 2709–2750.Google Scholar
- 20.Suda T, Demura H, Demura R, et al: Corticotropin-releasing factor-like activity in ACTH producing tumor. J Clin Endocrinol Metab 44440–446, 1977.Google Scholar
- 23.Zarate A, Kovacs K, Flores M, Moran C, Felix I: ACTH and CRF-producing bronchial carcinoid associated with Cushing’s syndrome. Clin Endocrinol 24:523–529, 1986.Google Scholar
- 24.Jessob DS, Cunnah D, Millar JGB, et al. A pheochromocytoma presenting with Cushing’s syndrome associated with increased concentrations of circulating corticotrophin-releasing factor. J Endocr 113:133–138, 1987.Google Scholar
- 25.O’Brien T, Young WF Jr, Davila DG, et al. Cushing’s syndrome associated with ectopic production of corticotrophin-releasing hormone, corticotrophin and vasopressin by a pheochromocytoma. Clin Endocrinol 37:460–467, 1992.Google Scholar
- 30.Kelley SR, Roth SI, Molitch ME: Corticotropin-releasing hormone (CRH) producing medullary Ca of thyroid (MCT) causing Cushing’s syndrome—confusion with crossed MEN syndromes. Presented at the 75th Annual Meeting of the Endocrine Society, Las Vegas, 1993 (Abstract #1362).Google Scholar