Medullary thyroid carcinoma with ectopic adrenocorticotropic hormone syndrome.

[cushing syndrome]

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 .