UNUSUAL PRESENTATION OF A THYROID MALIGNANCY: A CASE REPORT

Authors

  • Lakshmi S Sunkara Kurnool Medical College, Kurnool
  • Aparna Chinnam Kurnool Medical College, Kurnool
  • Lakshmi kasa Kurnool Medical College, Kurnool
  • Baleswari Golla Kurnool Medical College, Kurnool

DOI:

https://doi.org/10.55489/njmr.12012022894

Keywords:

Medullary thyroid carcinoma, Adrenocorticotropic hormone, Ectopic Cushing’s syndrome

Abstract

Medullary thyroid carcinoma is a rare malignancy. We report a case of Medullary thyroid carcinoma in a 56-year-old male patient. Patient presented with lower limb paresis and severe hypokalemia. Cushing’s syndrome is a rare complication of Medullary thyroid carcinoma [MTC] and is due to ectopic Adrenocorticotropic [ACTH] secretion by tumor cells. Cushing’s syndrome presents a challenging diagnostic and management issue in patients with MTC. Entire clinical history, laboratory investigations, microscopic pictures are discussed in detail.

References

Hoff AO, Hoff PM. Medullary thyroid carcinoma. Hematol Oncol Clin North Am. 2007 Jun;21((3)):475-88. Doi: https://doi.org/10.1016/j.hoc.2007.04.002 PMid:17548035

J. F. Moley, "Medullary thyroid carcinoma: management of lymph node metastases," Journal of the National Comprehensive Cancer Network, vol. 8, no. 5, pp. 549-556, 2010. Doi: https://doi.org/10.6004/jnccn.2010.0042 PMid:20495084

S. A. Wells, S. L. Asa, H. Dralle et al., "Revised American thyroid association guidelines for the management of medullary thyroid carcinoma," Thyroid, vol. 25, no. 6, pp. 567-610, 2015. Doi: https://doi.org/10.1089/thy.2014.0335 PMid:25810047 PMCid:PMC4490627

R. Cohen, J. Campos, M. C. Salaün et al., "Preoperative calcitonin levels are predictive of tumor size and postoperative calcitonin normalization in medullary thyroid carcinoma," -The Journal of Clinical Endocrinology & Metabolism, vol. 85, no. 2, p. 919, 2000. Doi: https://doi.org/10.1210/jc.85.2.919

S. L. Barbosa, P. Rodien, S. Leboulleux et al., "Endocrines ectopic adrenocorticotropic hormone-syndrome in medul-lary carcinoma of the thyroid: a retrospective analysis and review of the literature," ¬Thyroid, vol. 15, no. 6, pp. 618-623, 2005. Doi: https://doi.org/10.1089/thy.2005.15.618 PMid:16029131

A. A. Nella, M. B. Lodish, E. Fox et al., "Vandetanib success-fully controls medullary thyroid cancer-related Cushing syndrome in an adolescent patient," Journal of Clinical Endocrinology and Metabolism, vol. 99, pp. 3055-3059, 2014. Doi: https://doi.org/10.1210/jc.2013-4340 PMid:24617713 PMCid:PMC4154103

Mackenzie EJ, Mortimer RH. 2004. 6: Thyroid nodules and thyroid cancer. Medical Journal of Australia 180 242-247. Doi: https://doi.org/10.5694/j.1326-5377.2004.tb05894.x PMid:14984346

Bhanot P, Yang J, Schnadig VJ, Logroño R. 2007. Role of FNA cytology and immunochemistry in the diagnosis and management of medullary thyroid carcinoma: report of six cases and review of the literature. Diagnostic Cytopathology 35 285-292. Doi: https://doi.org/10.1002/dc.20502 PMid:17427218

M. Boscaro and G. Arnaldi, "Approach to the patient with possible Cushing's syndrome," ¬e Journal of Clinical Endocrinology & Metabolism, vol. 94, no. 9, pp. 3121-3131, 2009. Doi: https://doi.org/10.1210/jc.2009-0612 PMid:19734443

L. Matheny, J. Wilson, and H. Baum, "Ectopic ACTH pro-duction leading to diagnosis of underlying medullary thyroid carcinoma," Journal of Investigative Medicine High Impact Case Reports, vol. 4, no. 2, Article ID 232470961664398, 2016. Doi: https://doi.org/10.1177/2324709616643989 PMid:27141514 PMCid:PMC4837669

A. Chrisoulidou, K. Pazaitou-Panayiotou, E. Georgiou et al., "Ectopic Cushing's syndrome due to CRH secreting liver metastasis in a patient with medullary thyroid carcinoma," Hormones, vol. 7, no. 3, pp. 259-262, 2008. Doi: https://doi.org/10.1007/BF03401514 PMid:18694866

A. Isidori, G. Kaltsas, C. Pozza et al., "Extensive clinical experience: the ectopic adrenocorticotropin syndrome: clinical features, diagnosis, management, and long-term follow-up," The Journal of Clinical Endocrinology & Metabolism, vol. 91, no. 2, pp. 371-377, 2006. Doi: https://doi.org/10.1210/jc.2005-1542 PMid:16303835

Smallridge RC, Bourne K, Pearson BW, Van Heerden JA, Carpenter PC, Young WF. Cushing's syndrome due to medullary thyroid carcinoma: diagnosis by proopiomelanocortin messenger ribonucleic acid in situ hybridization. J Clin Endocrinol Metab. 2003 Oct;88((10)):4565-8. Doi: https://doi.org/10.1210/jc.2002-021796 PMid:14557423

Baudry C, Paepegaey AC, Groussin L. Reversal of Cushing's syndrome by vandetanib in medullary thyroid carcinoma. N Engl J Med. 2013 Aug;369((6)):584-6. Doi: https://doi.org/10.1056/NEJMc1301428 PMid:23924025

Zubair W.Baloch, Virginia A.LiVolsi. Thyroid and Parathyroid in Stacey E.Mills, editor, Sternberg's Diagnostic pathology, 6th edition, pp.557-9, Philadelphia, Wolters Kluwer,2015.

Giovanni Tallini and Thomas J.Giordano. Thyroid Gland In John R.Goldblum , editor, Rosai and Ackerman's Surgical Pathology, 11th edition, pp.527, Philadelphia, Elsevier,2018.

Downloads

Published

2022-03-31

How to Cite

Sunkara, L. S., Chinnam, A. ., kasa, L. ., & Golla, B. . (2022). UNUSUAL PRESENTATION OF A THYROID MALIGNANCY: A CASE REPORT. National Journal of Medical Research, 12(01), 7–9. https://doi.org/10.55489/njmr.12012022894

Issue

Section

Case Report