ArticleAACE endocrinology and diabetes
Ectopic Cushing Syndrome due to Metastatic Medullary Thyroid Cancer.
Article in AACE endocrinology and diabetes. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Management of ectopic Cushing syndrome in medullary thyroid carcinoma: from case reports to systematic literature review.Frontiers in endocrinology · 2026Pooled it
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background/Objective: Cushing syndrome (CS) is a life-threatening condition that occurs due to hypercortisolism. The most common cause of endogenous CS is adrenocorticotropic hormone (ACTH)-dependent CS caused by a pituitary adenoma (Cushing disease). Ectopic production of ACTH from tumors elsewhere in the body is rare and is most often associated with small cell lung cancer. This report describes a patient with ACTH-dependent CS secondary to metastatic medullary thyroid cancer (MTC), a rare cause of ectopic CS. Case Report: A 52-year-old man presented with progressive diarrhea, fatigue, muscle weakness, and hypokalemia. Initial investigations revealed metabolic alkalosis, elevated urinary potassium excretion, and fasting hyperglycemia. Evaluations confirmed ACTH-dependent hypercortisolism with elevated serum ACTH and urinary free cortisol levels. Imaging and fine needle aspiration confirmed MTC with metastatic lymph node involvement, supported by elevated serum calcitonin and carcinoembryonic antigen levels. Surgical intervention revealed extensive tumor invasion but was complicated by vascular injuries, resulting in postoperative hypoxic brain injury and fatality. Discussion: This case highlights the importance of early recognition and investigation of unexplained ACTH-dependent hypercortisolism. Delayed diagnosis complicates management, increases morbidity, and worsens outcomes. A systematic diagnostic approach-including biochemical markers, imaging, and cytology-is crucial in identifying rare causes of hypercortisolism. Conclusion: Early evaluation of persistent hypokalemia and hypercortisolism is essential to prevent delayed diagnosis of CS. This case highlights MTC as a rare source of ectopic ACTH secretion.
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