Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 May 17:2017:16-0110.
doi: 10.1530/EDM-16-0110. eCollection 2017.

ACTH-secreting medullary thyroid cancer: a case series

Ayanthi A Wijewardene  1 , Sarah J Glastras  2   3   4 , Diana L Learoyd  2   4 , Bruce G Robinson  2   4 , Venessa H M Tsang  2   4
Affiliations

ACTH-secreting medullary thyroid cancer: a case series

Ayanthi A Wijewardene et al. Endocrinol Diabetes Metab Case Rep. .

Abstract

Medullary thyroid cancer (MTC) is a rare neuroendocrine tumour that originates from the parafollicular cells of the thyroid gland. The most common presentation of MTC is with a single nodule; however, by the time of diagnosis, most have spread to the surrounding cervical lymph nodes. Cushing's syndrome is a rare complication of MTC and is due to ectopic adrenocorticotrophic hormone (ACTH) secretion by tumour cells. Cushing's syndrome presents a challenging diagnostic and management issue in patients with MTC. Tyrosine kinase inhibitors (TKI) previously used for the management of metastatic MTC have become an important therapeutic option for the management of ectopic ACTH in metastatic MTC. The article describes three cases of ectopic ACTH secretion in MTC and addresses the significant diagnostic and management challenges related to Cushing's syndrome in metastatic MTC.

Learning points: Medullary thyroid cancer (MTC) is a rare neuroendocrine tumour.Cushing's syndrome is a rare complication of MTC that has a significant impact on patients' morbidity and mortality.Tyrosine kinase inhibitors (TKI) provide an important therapeutic option for the management of ectopic ACTH in metastatic MTC.

PubMed Disclaimer

Figures

Figure 1
Figure 1
(A) Haematoxylin and eosin staining of MTC and (B) negative ACTH staining of MTC.
See this image and copyright information in PMC

References

    1. Mackenzie EJ, Mortimer RH. 2004. 6: Thyroid nodules and thyroid cancer. Medical Journal of Australia 180 242–247. - PubMed
    1. Wells SA, Jr, Asa SL, Dralle H, Elisei R, Evans DB, Gagel RF, Lee N, Machens A, Moley JF, Pacini F, et al. 2015. Revised american thyroid association guidelines for the management of medullary thyroid carcinoma. Thyroid 25 567–610. ( 10.1089/thy.2014.0335) - DOI - PMC - PubMed
    1. 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. ( 10.1002/dc.20502) - DOI - PubMed
    1. Rendl G, Manzl M, Hitzl W, Sungler P, Pirich C. 2008. Long-term prognosis of medullary thyroid carcinoma. Clinical Endocrinology 69 497–505. ( 10.1111/j.1365-2265.2008.03229.x) - DOI - PubMed
    1. Barbosa SL, Rodien P, Leboulleux S, Niccoli-Sire P, Kraimps JL, Caron P, Archambeaud-Mouveroux F, Conte-Devolx B, Rohmer V, Groupe d’Etude des Tumeurs Endocrines 2005. Ectopic adrenocorticotropic hormone-syndrome in medullary carcinoma of the thyroid: a retrospective analysis and review of the literature. Thyroid 15 618–623. ( 10.1089/thy.2005.15.618) - DOI - PubMed

LinkOut - more resources