Thymic Atypical Carcinoid with Cyclical Cushing?s Syndrome in A 7-Year-Old Boy: a Case Report and Review of the Literature

Qiang Mi,Min-Zhi Yin

doi:10.4172/2165-8048.1000173

Abstract

Thymic carcinoid tumors very rarely occur during childhood and are often associated with the production of adrenocorticotropic hormone (ACTH), which leads to Cushing’s syndrome. We describe a 7-year-old male patient with a thymic atypical carcinoid tumor who presented with cyclical Cushing’s syndrome. His tumor was initially overlooked on computed tomography scanning in the anterior mediastinum, and was later identified by magnetic resonance imaging scanning. There was an interval of 154 days observed between periods of cyclic hormone production. In addition, we discuss the findings of our literature search of the PubMed database. This report emphasizes the importance of considering thymic carcinoid in the differential diagnosis of ectopic ACTH production in children.

Highlights

Carcinoid tumors of the thymus are separate neoplasms from conventional thymomas
Thymic carcinoid tumors very rarely occur during childhood and are often associated with the production of adrenocorticotropic hormone (ACTH), which leads to Cushing’s syndrome
We describe a 7-year-old male patient with a thymic atypical carcinoid tumor who presented with cyclical Cushing’s syndrome

Summary

Background

Carcinoid tumors of the thymus are separate neoplasms from conventional thymomas. These tumors are thought to arise from the foregut and generally are not associated with carcinoid syndrome [1]. We described the clinical features and outcomes of a pediatric patient with a thymic atypical carcinoid tumor, who presented with cyclical Cushing’s syndrome, treated in our hospital. A 7-year-old boy was referred for further evaluation of rapid weight gain and generalized edema in May 2012 At presentation, he was noted to have facial puffiness, and he rapidly developed pitting edema in his lower limbs. The weight of this patient spontaneously decreased to 24 kg, blood pressure was 120/80 mmHg; potassium level was 3.52 mmol/L, with normal cortisol and ACTH level) except for the full face. This remission persisted for 5 months and was followed by recurrent hypercortisolemia.

Findings

Discussion

Conclusion