Endocrine Abstracts

Bilateral laparoscopic adrenalectomy offers good palliation for medullary thyroid cancer associated with ectopic acth secretion

SL Hyer, M Haq & CL Harmer

Royal Marsden NHS Foundation Trust, London, United Kingdom.

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We present three cases of metastatic medullary thyroid carcinoma who developed severe Cushing’s syndrome from ectopic production of ACTH by the tumour. Following total thyroidectomy and external beam radiotherapy, the patients had remained symptom-free for 4, 9 and 25 years after initial presentation despite the presence of widespread hepatic metastases. However, with the onset of Cushing’s syndrome, patients became unwell with severe muscle weakness and lethargy. Medical treatment with metyrapone proved ineffective in alleviating symptoms of hypercortisolism which lasted 5, 7 and 18 months respectively. Rapid palliation was achieved following bilateral adrenalectomy. We suggest that this treatment is considered early in patients with indolent malignancies and ectopic ACTH in order to improve their quality of life.

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Endocrine Abstracts (2005) 10 P39