The occurrence of adrenocorticotropic hormone-independant Cushing

Hayfa Farid; Ghada Saad; Taieb Ach; Hamza El Fekih; Abdelkarim Asma Ben; Yosra Hasni; Maaroufi Ameml; Maha Kacem; Chadli Molka; Koussay Ach

doi:10.1530/endoabs.90.EP653

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Endocrine Abstracts (2023) 90 EP653 | DOI: 10.1530/endoabs.90.EP653

ECE2023 Eposter Presentations Endocrine-related Cancer (80 abstracts)

The occurrence of adrenocorticotropic hormone-independant Cushing’s syndrome in a woman with the history of medullary thyroid carcinoma: a case report

Hayfa Farid ¹ , Ghada Saad ^1,2 , Taieb Ach ^1,2 , El Fekih Hamza ^1,2 , Asma Ben Abdelkarim ^1,2 , Yosra Hasni ^1,2 , Maaroufi Ameml ^1,2 , Maha Kacem ^1,2 , Chadli Molka ^1,2 & Koussay Ach ^1,2

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Author affiliations

¹Hospital Farhat Hached, Endocrinology-Diabetology Department, Sousse, Tunisia; ²Ibn El Jazzar Medical Faculty of Sousse, Sousse, Tunisia

Background: Medullary thyroid carcinoma (MTC) is a rare neuroendocine tumor that that may be associated with paraneoplastic ACTH-dependent cushing syndrome. There are few case reports on the coexistence of medullary thyroid carcinoma and adrenal adenoma with ACTH-independent Cushing syndrome.

Case presentation: We report the case of a 42-year-old woman, with no family history of endocrine malignancy or endocrine disorders. She underwent total thyroidectomy for MTC. During follow-up, she presented with high blood pressure, hypokalemia, diabetes, and osteoporosis. These symptoms led to the suspicion of Cushing’s syndrome. The investigations indeed showed an excessive production of cortisol. contrary to what was expected, Cushing’s syndrome is of adrenal origin. Abdominal CT scan showed adrenal adenoma.

Conclusions: We present a rare case of a patient with MTC and Cushing’s syndrome. The co-occurrence of two endocrine tumors with different origins is rare. To date, no known genetic syndrome can account for this combination of neoplastic thyroid and adrenal pathologies, future research may prove differently.