title: Medullary thyroid carcinoma with ectopic adrenocorticotropic hormone syndrome.
abstract: Ectopic adrenocorticotropic hormone (ACTH) syndrome is caused most frequently by a bronchial carcinoid tumor or by small cell lung cancer. Medullary thyroid carcinoma (MTC) is a rare etiology of ectopic ACTH syndrome. We describe a case of Cushing syndrome due to ectopic ACTH production from MTC in a 48-year-old male. He was diagnosed with MTC 14 years ago and underwent total thyroidectomy, cervical lymph node dissection and a series of metastasectomies. MTC was confirmed by the pathological examination of the thyroid and metastatic mediastinal lymph node tissues. Two years after his last surgery, he developed Cushingoid features, such as moon face and central obesity, accompanied by uncontrolled hypertension and new-onset diabetes. The laboratory results were compatible with ectopic ACTH syndrome. A bilateral adrenalectomy improved the clinical and laboratory findings that were associated with Cushing syndrome. This is the first confirmed case of ectopic ACTH syndrome caused by MTC in Korea.
authors.affiliation: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Hong Seok
authors.initials: HS
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Min Joo
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Chae Ho
authors.initials: CH
authors.lastname: Moon
authors.affiliation: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Jong Ho
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Ha Ra
authors.initials: HR
authors.lastname: Ku
authors.affiliation: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Geon Wook
authors.initials: GW
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Im Il
authors.initials: II
authors.lastname: Na
authors.affiliation: Department of Pathology, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Seung-Sook
authors.initials: SS
authors.lastname: Lee
authors.affiliation: Department of Otorhinolaryngology, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Byung-Chul
authors.initials: BC
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Hong Il
authors.initials: HI
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Yun Hyi
authors.initials: YH
authors.lastname: Ku
keywords: ACTH syndrome, ectopic; Cushing syndrome; Medullary thyroid carcinoma
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