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Ectopic Cushing's syndrome due to CRH secreting liver metastasis in a patient with medullary thyroid carcinoma.

TitleEctopic Cushing's syndrome due to CRH secreting liver metastasis in a patient with medullary thyroid carcinoma.
Publication TypeJournal Article
Year of Publication2008
AuthorsChrisoulidou, A., Pazaitou-Panayiotou K., Georgiou E., Boudina M., Kontogeorgos G., Iakovou I., Efstratiou I., Patakiouta F., & Vainas I.
JournalHormones (Athens)
Volume7
Issue3
Pagination259-62
Date Published2008 Jul-Sep
ISSN1109-3099
KeywordsAdrenocorticotropic Hormone, Biopsy, Fine-Needle, Carcinoma, Medullary, Corticotropin-Releasing Hormone, Cushing Syndrome, Fatal Outcome, Hormones, Ectopic, Humans, Hydrocortisone, Immunohistochemistry, Liver Neoplasms, Male, Middle Aged, Thyroid Neoplasms, Treatment Refusal
Abstract

Ectopic production of CRH by a medullary thyroid carcinoma or its metastases is a rare cause of ectopic Cushing's syndrome (ECS). We report a 45-year old male with medullary thyroid carcinoma (MTC), who, 24 years following the initial diagnosis, presented with clinical and biochemical evidence of an ACTH dependent Cushing's syndrome. Rapid deterioration of his clinical condition and elevated cortisol levels were observed. Computed tomographic imaging of the abdomen revealed extensive liver metastases. The patient underwent fine needle aspiration biopsy of a liver lesion and immunohistochemistry showed that the cells expressed calcitonin, carcino-embryonic antigen and synaptophysin. Further analysis revealed that the material also expressed CRH. This is an unusual case of a CRH-secreting liver metastasis from a medullary thyroid carcinoma 24 years after the initial diagnosis of MTC.

DOI10.1007/BF03401514
Alternate JournalHormones (Athens)
PubMed ID18694866

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