Abstract
Medullary thyroid carcinomas (MTC) constitute about 5 to 7 % of thyroid neoplasms. They originate from parafollicular C-cells which can secrete adrenocorticotropic hormone (ACTH) and/or corticotropin-releasing factor (CRF) in abnormally high concentrations, potentially causing paraneoplastic Cushing's Syndrome (CS).We report on a 42-year-old male patient with a ten year history of metastatic medullary thyroid carcinoma suffering from paraneoplastic Cushing's Syndrome caused by ectopic hypersecretion of ACTH and a simultaneous Cortisol producing adrenal metastasis.
Highlights
Medullary thyroid carcinoma (MTC) is relatively rare and represents 3% to 10% of all thyroid carcinomas [1]
The C-cells potentially produce peptides such as adrenocorticotropic hormone (ACTH) and/or corticotropin-releasing factor (CRF) in abnormally high concentrations which may lead to paraneoplastic Cushing's Syndrome (CS)
We report on a 42-year-old male patient with a 10-year history of MTC
Summary
Medullary thyroid carcinoma (MTC) is relatively rare and represents 3% to 10% of all thyroid carcinomas [1]. Another possible cause for Cushing's Syndrome is an adrenal gland tumor primary or as a metastasis [10]. The combination of both in a single patient has not been reported to date. The patient underwent multiple tumor and metastases resections within the past 10 years He received a modified radical neck dissection and a clearance of the upper mediastinum due to progressive tracheal compression. Three weeks before referral to our unit he developed multiple episodes of strong muscular weakness which was temporarily so extreme that it led to paralysis He developed diabetes and laboratory values showed very low potassium levels, necessitating continuous intravenous potassium replacement. He was transferred to the intensive care unit, but despite aggressive treatment, died a few days later
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