دورية أكاديمية
Ectopic Cushing's syndrome from a corticotropin-releasing hormone-secreting medullary thyroid carcinoma: a rare pitfall of inferior petrosal sinus sampling.
| العنوان: | Ectopic Cushing's syndrome from a corticotropin-releasing hormone-secreting medullary thyroid carcinoma: a rare pitfall of inferior petrosal sinus sampling. |
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| المؤلفون: | Mäkinen VN; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.; Department of Internal Medicine, Regional Hospital, Horsens, Denmark., Horskær Madsen S; Department of Pathology, Aarhus University Hospital, Aarhus, Denmark., Ji Riis-Vestergaard M; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.; Department of Internal Medicine, Gødstrup Hospital, Herning,Denmark., Bjerre M; Department of Clinical Medicine, Aarhus University, Aarhus University Hospital, Aarhus, Denmark., Bønløkke Pedersen S; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark., Asa SL; Department of Pathology, University Health Network, Toronto,Canada., Rolighed L; Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark., Lunde Jørgensen JO; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.; Department of Clinical Medicine, Aarhus University, Aarhus University Hospital, Aarhus, Denmark., Ornstrup MJ; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark. |
| المصدر: | Endocrinology, diabetes & metabolism case reports [Endocrinol Diabetes Metab Case Rep] 2023 Sep 28; Vol. 2023 (3). Date of Electronic Publication: 2023 Sep 28 (Print Publication: 2023). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Bioscientifica Country of Publication: England NLM ID: 101618943 Publication Model: Electronic-Print Cited Medium: Print ISSN: 2052-0573 (Print) Linking ISSN: 20520573 NLM ISO Abbreviation: Endocrinol Diabetes Metab Case Rep Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: Bristol : Bioscientifica, [2013]- |
| مستخلص: | Summary: This case report describes a rare presentation of ectopic Cushing's syndrome (CS) due to ectopic corticotropin-releasing hormone (CRH) production from a medullary thyroid carcinoma (MTC). The patient, a 69-year-old man, presented with symptoms of muscle weakness, facial plethora, and easy bruising. An inferior petrosal sinus sampling test (IPSS) demonstrated pituitary adrenocorticotrophic hormone (ACTH) secretion, but a whole-body somatostatin receptor scintigraphy (68Ga-DOTATOC PET/CT) revealed enhanced uptake in the right thyroid lobe which, in addition to a grossly elevated serum calcitonin level, was indicative of an MTC. A 18F-DOPA PET/CT scan supported the diagnosis, and histology confirmed the presence of MTC with perinodal growth and regional lymph node metastasis. On immunohistochemical analysis, the tumor cell stained positively for calcitonin and CRH but negatively for ACTH. Distinctly elevated plasma CRH levels were documented. The patient therefore underwent thyroidectomy and bilateral adrenalectomy. This case shows that CS caused by ectopic CRH secretion may masquerade as CS due to a false positive IPSS test. It also highlights the importance of considering rare causes of CS when diagnostic test results are ambiguous. Learning Points: Medullary thyroid carcinoma may secrete CRH and cause ectopic CS. Ectopic CRH secretion entails a rare pitfall of inferior petrosal sinus sampling yielding a false positive test. Plasma CRH measurements can be useful in selected cases. |
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| تواريخ الأحداث: | Date Created: 20230928 Latest Revision: 20231104 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC10563613 |
| DOI: | 10.1530/EDM-23-0057 |
| PMID: | 37767685 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2052-0573 |
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| DOI: | 10.1530/EDM-23-0057 |