1/55. Ectopic ACTH syndrome due to thymic carcinoid tumor in a girl.An 8 year-old girl had a cushingoid appearance for six months. Hormone study showed extremely high serum levels of cortisol (> 60 micrograms/dl) and adrenocorticotropic hormone (930 pg/ml). Initial chest X-ray showed nothing unusual, but a technetium-99mm MIBI scan showed an accumulation lesion in the left upper chest cavity. Chest magnetic resonance imaging demonstrated that the mass was in the superior anterior mediastinum. She had complete removal of the tumor with partial thymectomy. The pathology revealed a thymic carcinoid tumor. Carcinoid tumors of the thymus are extremely rare in children and they usually present with Cushing's syndrome. To our knowledge, this is the youngest patient who has ever been reported with this disease.- - - - - - - - - - ranking = 1keywords = hormone (Clic here for more details about this article) |
2/55. Small cell neuroendocrine carcinoma of the thymus complicated by Cushing's syndrome. Report of a 58-year-old woman with a 3-year history of hypertension.A 58-year-old woman with a history of Cushing's syndrome for three years presented with a mediastinal mass and received the diagnosis of small cell neuroendocrine carcinoma of the thymus invading the pericardium. On immunohistochemical study, the neoplastic cells reacted with antibodies against cytokeratin, epithelial membrane antigen, neuron-specific enolase, chromogranin, synaptophysin, and ACTH. Clinicopathologic findings of this rare case of ectopic adrenocorticotropic hormone (ACTH) syndrome are discussed with a literature review.- - - - - - - - - - ranking = 1keywords = hormone (Clic here for more details about this article) |
3/55. Neuroendocrine carcinoma (carcinoid) of the thymus associated with Cushing's syndrome.Neuroendocrine carcinoma (carcinoid) of the thymus associated with Cushing's syndrome is a rare disease. Recent evidence suggests that these tumors form part of a continuous spectrum ranging from well-differentiated carcinomas to small cell carcinomas. We report two new cases and review the 23 cases reported in the literature since 1972. The different diagnostic modalities are discussed, and an algorithm for the diagnosis of ectopic secretion of adrenocorticotropin (ACTH) is presented. In the future, the advent of radiologic and nuclear imaging as well as more accurate workup should help to diagnose these tumors at an earlier stage and improve the long-term outcome.- - - - - - - - - - ranking = 6.4193757882906keywords = secretion (Clic here for more details about this article) |
4/55. Pigmented spindle cell carcinoid tumour of the thymus with ectopic adrenocorticotropic hormone secretion: report of a rare variant and differential diagnosis of mediastinal spindle cell neoplasms.AIMS: A variety of histological variants of thymic carcinoid tumour have been described. A rare case of pigmented spindle cell carcinoid tumour of the thymus is documented and compared with the reported cases of thymic pigmented carcinoid tumour in the literature, with a discussion of the differential diagnosis of spindle cell tumours of the mediastinum. methods AND RESULTS: A thymic tumour with ectopic adrenocorticotropic hormone (ACTH) secretion was resected from a 24-year-old man suffering from Cushing's syndrome. Histological, immunohistochemical, and ultrastructural studies revealed an ACTH-producing spindle cell carcinoid tumour harbouring pigmented melanocytes. Among four thymic pigmented carcinoid tumours reported before, only one was similar to the present case by being also an ACTH-secreting pigmented spindle cell thymic carcinoid tumour. The clinicopathological features of this tumour distinguish it from a spindle cell thymoma, spindle cell thymic carcinoma, and other mediastinal spindle cell tumours. CONCLUSIONS: This case illustrates an extremely rare variant of thymic carcinoid tumour exhibiting a spindle cell morphology and harbouring pigmented melanocytes. awareness of this histological variant is important in the differential diagnosis of spindle cell tumours of the mediastinum.- - - - - - - - - - ranking = 37.096878941453keywords = secretion, hormone (Clic here for more details about this article) |
5/55. Paraneoplastic Cushing's syndrome associated to locally advanced thymic carcinoid tumor.BACKGROUND: Thymic carcinoid is a frequent cause of Cushing's syndrome due to ectopic adrenocorticotropin secretion. histology and immunohistochemistry allow differential diagnosis from other epithelial thymic tumors, such as thymomas and thymic carcinomas. The term used to name this tumor is confusing, since it is a malignant neuroendocrine neoplasm, and therapeutic approaches need to bear that in mind. CASE REPORT: Unlike most cases of thymic carcinoid associated to Cushing's syndrome that had distant metastases at diagnosis, we report a 50-year-old male who presented with Cushing's syndrome and was diagnosed with thymic carcinoid without distant metastases. Multimodal treatment with surgery, radiotherapy and chemotherapy (cisplatin plus etoposide) induced a complete clinical and biochemical remission lasting for 46 months.- - - - - - - - - - ranking = 6.4193757882906keywords = secretion (Clic here for more details about this article) |
6/55. Ectopic growth hormone-releasing hormone secretion by thymic carcinoid tumour.The case of a 33-year-old-woman with multiple endocrine neoplasia type 1 (MEN1) syndrome and acromegaly due to ectopic growth hormone-releasing hormone (GHRH) secretion by a thymic carcinoid tumour is reported. immunohistochemistry revealed positive immunoreactivity for GHRH, vasoactive intestinal polypeptide, somatostatin and alpha-subunit in the tumour cells. A previously undescribed new germ line mutation of the MEN1 protein gene was revealed.- - - - - - - - - - ranking = 42.096878941453keywords = secretion, hormone (Clic here for more details about this article) |
7/55. syndrome of inappropriate secretion of antidiuretic hormone due to malignant thymoma.The authors present the case of a 51-year-old female with a syndrome of inappropriate secretion of antidiuretic hormone (SIADH) due to a malignant thymoma. Laboratory examinations of the patient showed hyponatremia, plasma hypoosmolarity in the presence of concentrated urine and normal urine excretion of sodium. CT revealed a mass lesion in the mediastinum. A biopsy of the mediastinal mass was performed and the diagnosis of thymoma with SIADH was established. This is a rare description of a malignant thymoma associated with SIADH.- - - - - - - - - - ranking = 2914.4778225342keywords = inappropriate secretion, antidiuretic hormone, antidiuretic, secretion, hormone (Clic here for more details about this article) |
8/55. Thymic parathyroid carcinoma and postoperative hungry bone syndrome.OBJECTIVE: To describe a case of parathyroid carcinoma localized to ectopic parathyroid tissue within the thymus and the development of hungry bone syndrome postoperatively. methods: We present pertinent clinical, radiologic, pathologic, and laboratory details of the study patient and discuss the relevant literature. RESULTS: A 33-year-old man who presented with only symptoms of fatigue and depression was found to have high serum calcium, parathyroid hormone, and alkaline phosphatase levels. A sestamibi scan revealed evidence of activity adjacent to the sternum. He underwent neck exploration after selective staining of the parathyroid glands with methylene blue dye. A mass was found in the thymic bed, and the pathologic features were consistent with parathyroid carcinoma. Postoperatively, symptoms and signs of hypocalcemia developed despite normal serum calcium levels. CONCLUSION: physicians should be aware that (1) parathyroid carcinoma may originate wherever ectopic parathyroid tissue is found and patients may have only nonspecific symptoms, (2) wide local excision is imperative if carcinoma is suspected, and (3) symptoms and signs of hypocalcemia may be evident even when the serum calcium concentration is normal, if it has rapidly declined from a high level.- - - - - - - - - - ranking = 1keywords = hormone (Clic here for more details about this article) |
9/55. Primary thymic carcinoid with Cushing's syndrome.In a 52-year-old Caucasian man osteopoikilosis had been misdiagnosed roentgenologically 2 years before his death. Gradually he developed Cushing's syndrome and ultimately superior vena caval obstruction. At autopsy a primary thymic carcinoid with extensive osteoblastic bone metastasis was found. Immunohistochemically the tumor was shown to be positive for adrenocorticotropic hormone (ACTH), cytokeratin (KL1), neuron-specific enolase, synaptophysin, chromogranin and glucagon. Remarkably the tumour was negative for serotonin despite high urinary hydroxyindolacetic acid levels. Bilateral hyperplasia of the adrenal cortex was found. The adenohypophysis showed a considerable reduction of ACTH-producing cells and numerous Crooke's cells with a characteristic immunohistochemical pattern.- - - - - - - - - - ranking = 1keywords = hormone (Clic here for more details about this article) |
10/55. Thymic atypical carcinoid with Cushing's syndrome manifesting in the terminal stage.A 56-year-old man with recurrent thymic atypical carcinoid presented with Cushing's syndrome only in the terminal stage. Eighteen months after the resection of an anterior mediastinal mass, he presented with hypernatremia and hypokalemia with high serum levels of adrenocorticotropic hormone and cortisol, and died two months later. An autopsy demonstrated multiple metastases of the tumor to the mediastinum, lungs, heart, liver, kidneys, bone, pituitary gland, and ocular muscles. The adrenocorticotropic hormone level of the tumor tissue was 26,000 pg/g.- - - - - - - - - - ranking = 2keywords = hormone (Clic here for more details about this article) |
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