Volume 4, Issue 4, December 2019, Page: 98-103
Thymic Neuroendocrine Tumour Results Cushing’s Syndrome
Taher Manzary, Department of Endocrinology, Tabriz University of Medical Sciences, Tabriz, Iran
Amir Teimouri Dereshgi, Department of Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
Vahideh Sadra, Department of Endocrinology, Tabriz University of Medical Sciences, Tabriz, Iran
Ali Jamshidi Fard, Department of Endocrinology, Tabriz University of Medical Sciences, Tabriz, Iran
Leila Teimouri Dereshgi, Department of Pediatrics, Tabriz University of Medical Sciences, Tabriz, Iran
Touba Tarvirdizadeh, Department of Internal Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
Received: Aug. 5, 2019;       Accepted: Nov. 5, 2019;       Published: Nov. 12, 2019
DOI: 10.11648/j.ijde.20190404.12      View  32      Downloads  9
Abstract
Background: Thymic Neuroendocrine Tumor (TNET) is a rare clinical condition with approximate incidence rate of 2–5%. Carcinoid tumor of thymus with Cushing’s syndrome (CS) is also a rare co-morbid condition. Case information: Here we report a case of a 22-year-old gentleman presented with uncommon features suggestive of CS. He was evaluated and diagnosed with ectopic Adrenocorticotropic hormone (ACTH)–dependent CS due to a TNET. Results: Extensive thymectomy was performed and histopathology confirmed the diagnosis of thymic carcinoma with neuroendocrine differentiation and local and pericardial invasion. Conclusion: Thymic carcinomas may present with symptoms due to mass effect but Cushing syndrome is the most common endocrine manifestation of these tumors. Surgery is the most effective treatment of thymic carcinoma, although chemotherapy and radiotherapy also have been reported to be effective in some cases.
Keywords
Cushing's Syndrome, Thymic Carcinoma, Neuroendocrine Tumor
To cite this article
Taher Manzary, Amir Teimouri Dereshgi, Vahideh Sadra, Ali Jamshidi Fard, Leila Teimouri Dereshgi, Touba Tarvirdizadeh, Thymic Neuroendocrine Tumour Results Cushing’s Syndrome, International Journal of Diabetes and Endocrinology. Vol. 4, No. 4, 2019, pp. 98-103. doi: 10.11648/j.ijde.20190404.12
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Newell-Price J Bertagna X Grossman A B Nieman L K 2006 Cushing’s syndrome. Lancet 367 1605–1617. (doi: 10.1016/S0140-6736(06)68699-6).
[2]
Lacroix A, Feelders RA, Stratakis CA, et al. Cushing's syndrome. Lancet. 2015 Aug 29; 386 (9996): 913-27.
[3]
Shields TW, LoCicero JI, Reed CE, Feins RH. General thoracic surgery. 7th edn: Lippincott Williams & Wilkins. 2009.
[4]
Ose N, Maeda H, Inoue M, Morii E, Shintani Y, Matsui H, et al. Results of treatment for thymic neuroendocrine tumours: multicentreclinicopathological study. Interact Cardiovasc Thorac Surg. 2018; 26: 18-24.
[5]
Aghajanzadeh M, Alavi A, Aghajanzadeh G, Massahania S. Stiff man syndrome with invasive thymic carcinoma. Arch Iran Med. 2013; 16: 195-156.
[6]
de Perrot M, Spiliopoulos A, Fischer S, Totsch M, Keshavjee S. Neuroendocrine carcinoma (carcinoid) of the thymus associated with Cushing’s syndrome. Ann Thor Surg. 2002; 73: 675-681.
[7]
Aghajanzadeh M, Alavy A, Hoda S, Mohammadi F. Carcinoid tumor of lung with Cushing’s syndrome. Arch Iran Med. 2007; 10: 94-6.
[8]
Fernandez-Fernandez F, Halperin I, Manzanares J, Flores L, Lomena F, Vilardell E. Localization and postoperative follow-up of a bronchial carcinoid tumor causing Cushing’s syndrome by 111 In-DTPA labeled octreotide scintigraphy. J Endocrinol Invest. 1997; 20: 327-330.
[9]
S. Sharma, L. K. Nieman, R. A. Feelders. Clin Epidemiol, 7 (2015), pp. 281-293.
[10]
Psychiatric aspects of Cushing's syndrome. Kelly WF QJM. 1996 Jul; 89 (7): 543-51.
[11]
Broder MS, Neary MP, Chang E, et al: Incidence of Cushing’s syndrome and Cushing’s disease in commercially-insured patients <65 years old in the United States. Pituitary 2015; 18: 283–289.
[12]
A thymic neuroendocrine tumor in a young female: a rare cause of relapsing and remitting Cushing’s syndrome in Endocrinology, Diabetes & Metabolism Case Reports, Authors: M J Trott 1, G Farah 1, V J Stokes 1, L M Wang 1 and A B Grossman 1, volume 2016, issue 1.
[13]
Guaraldi F, Salvatori R J Am Board Fam Med. 2012 Mar-Apr; 25 (2): 199-208.
[14]
Bansal V, Asmar N, Selman W, Arafah B. Pitfalls in the Diagnosis and Management of Cushing's Syndrome. Neurosurg Focus. 2015; 38: 1–11.
[15]
Ilias I Torpy D J Pacak K Mullen N Wesley R A Nieman L K 2005 Cushing’s syndrome due to ectopic corticotropin secretion: twenty years’ experience at the National Institutes of Health. Journal of Clinical Endocrinology and Metabolism 90 4955–4962. (doi: 10.1210/jc.2004-2527).
[16]
Isidori A M Kaltsas G A Pozza C Frajese V Newel-Price J Reznek D H Jenkins P J Monson J P Grossman A B Besser G M 2006 The ectopic adrenocorticotropin clinical features, diagnosis, management, and long-term follow up. Journal of Clinical Endocrinology and Metabolism 91 371–377. (doi: 10.1210/jc.2005-1542).
[17]
Leyton O Turnbull H M Bratton A B 1931 Primary cancer of the thymus with pluriglandular disturbance. Journal of Pathology and Bacteriology 34 635–660. (doi: 10.1002/(ISSN)1555-2039).
[18]
Multidisciplinary treatment of advanced thymic neuroendocrine carcinoma (carcinoid): report of a successful case and review of the literature. Filosso PL, Actis Dato GM, Ruffini E, Bretti S, Ozzello F, Mancuso M. J Thorac Cardiovasc Surg. 2004 Apr; 127 (4): 1215-9.
[19]
Neuroendocrine carcinoma (carcinoid) of the thymus associated with Cushing's syndrome. de Perrot M, Spiliopoulos A, Fischer S, Totsch M, Keshavjee S. Ann Thorac Surg. 2002 Feb; 73 (2): 675-81.
[20]
Amin MB, Edge SB, Greene FL, Byrd DR, Brookland RK, Washington MK, eds. AJCC Cancer Staging Manual. 8th ed. New York: Springer; 2017.
[21]
Neary NM, Lopez Chavez A Abel B S Boyce A M Schaub N Kwong K Stratakis C A Moran C A Giaccone G Nieman L K 2012 Neuroendocrine ACTH-producing tumor of the thymus – experience with 12 patients over 25 years. Journal of Clinical Endocrinology and Metabolism 97 2223–2230. (doi: 10.1210/jc.2011-3355).
[22]
Syncope in a patient with a large left ventricular hydatid cyst: An unusual presentation, Beheshtirouy, Samad et al. International Journal of Cardiology, Volume 172, Issue 3, e385-e386.
[23]
Brambilla E, Nicholson AG, Yatabe Y, Austin JH, Beasley MB, et al. The 2015 World Health Organization Classification of Lung Tumors: Impact of Genetic, Clinical and Radiologic Advances Since the 2004 Classification. J Thorac Oncol. 2015 Sep. 10 (9): 1243-60.
[24]
Survival and response after peptide receptor radionuclide therapy with [90Y-DOTA0, Tyr3] octreotide in patients with advanced gastroenteropancreatic neuroendocrine tumors. Valkema R, Pauwels S, Kvols LK, Barone R, Jamar F, Bakker WH, Kwekkeboom DJ, Bouterfa H, Krenning EP. Semin Nucl Med. 2006 Apr; 36 (2): 147-56.
[25]
Peptide receptor radionuclide therapy with 177Lu-octreotate in patients with foregut carcinoid tumours of bronchial, gastric and thymic origin. van Essen M, Krenning EP, Bakker WH, de Herder WW, van Aken MO, Kwekkeboom DJ. Eur J Nucl Med Mol Imaging. 2007 Aug; 34 (8): 1219-27.
[26]
Primary neuroendocrine tumors of the thymus. Chaer R, Massad MG, Evans A, Snow NJ, Geha AS. Ann Thorac Surg. 2002 Nov; 74 (5): 1733-40.
[27]
Maroun J, Kocha W, Kvols L, Bjarnason G, Chen E, Germond C, et al. Guidelines for the diagnosis and management of carcinoid tumours. Part 1: the gastrointestinal tract. A statement from a Canadian National Carcinoid Expert Group. Curr Oncol. 2006; 13: 67.
[28]
Nakamura Y, Kunitoh H, Kubota K, Sekine I, Shinkai T, Tamura T, et al. Platinum-based chemotherapy with or without thoracic radiation therapy in patients with unresectable thymic carcinoma. Jpn J Clin Oncol. 2000; 30: 385-388.
[29]
Moran CA, Suster S. Primary neuroendocrine carcinoma (thymic carcinoid) of the thymus with prominent oncocytic features: a clinicopathologic study of 22 cases. Mod Pathol. 2000; 13: 489.
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