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Endocrinol Metab. 2014 Mar;29(1):96-100. English. Case Report. https://doi.org/10.3803/EnM.2014.29.1.96
Choi HS , Kim MJ , Moon CH , Yoon JH , Ku HR , Kang GW , Na II , Lee SS , Lee BC , Park YJ , Kim HI , Ku YH .
Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea. kyh@kirams.re.kr
Department of Pathology, Korea Cancer Center Hospital, Seoul, Korea.
Department of Otorhinolaryngology, Korea Cancer Center Hospital, Seoul, Korea.
Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
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.

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