[Cushing's syndrome caused by ectopic production of CRF by a medullary carcinoma of the thyroid body].
A 58-yr-old man presented a Cushing's syndrome gradually developed for two years, and a cervical tumor. Urinary free cortisol and 17-hydroxy-corticosteroids were elevated and non suppressible under high dose dexamethasone (8 mg a day X 2 days). Plasma calcitonin (7,200 pg/ml), CEA (803 ng/l), beta LPH (624 pg/ml), and CRF (29 pg/ml) were elevated. Total thyroidectomy revealed a medullary carcinoma of the thyroid. Postoperatively the Cushing's syndrome disappeared and plasma CRF became undetectable although plasma calcitonin remained elevated. One out of 3 CRF antisera tested for immunocytology was positive in 10 to 30% of the cells. In tumor extract, CRF (RIA) concentration was 4.75 ng/g. There was no detectable ACTH in the tumor by biochemical as well as immunocytochemical method. In the present report, the next evidences are--for the first time--simultaneously present to demonstrate an ectopic secretion of CRF by a medullary thyroid carcinoma: presence of CRF in systemic blood being undetectable after surgery; cure of the clinical and biological features of Cushing's syndrome after thyroidectomy; characterization of CRF immunoreactivity in tumor. Taken together, the radioimmunological and the immunocytochemical data suggest the production of several molecular forms of CRF.
Tourniaire
J
J
Clinique Endocrinologique de l'Université Claude Bernard, Faculté Lyon-Sud.
Rebattu
B
B
Conte-Devolx
B
B
Trouillas
J
J
Grino
M
M
Berger-Dutrieux
N
N
Peix
J L
JL
Pugeat
M
M
D002277:Carcinoma / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D003346:Corticotropin-Releasing Hormone / Q000378:metabolism*; D003480:Cushing Syndrome / Q000097:blood / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013964:Thyroid Neoplasms / Q000150:complications / Q000378:metabolism* / Q000473:pathology
D003346:Corticotropin-Releasing Hormone
Syndrome de Cushing secondaire à la production ectopique de CRF par un carcinome médullaire du corps thyroïde.