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Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1968 Mar;21(2):129–135. doi: 10.1136/jcp.21.2.129

Thyroid carcinoma and Cushing's syndrome

A report of two cases with a review of the common features of the `non-endocrine' tumours associated with Cushing's syndrome

E D Williams 1,2, A M Morales 1,2, R C Horn 1,2
PMCID: PMC473704  PMID: 4301476

Abstract

Two cases of thyroid carcinoma and Cushing's syndrome are reported. Nine other previously published cases of this association are reviewed: in one the thyroid tumour was described as medullary, in two as papillary, and in the other six as anaplastic, undifferentiated, atypical, or solid carcinoma. Both of our own cases were medullary carcinomas of the thyroid, and on reviewing the histology of five of the other cases all proved to be medullary carcinoma with identifiable amyloid in the stroma. A consideration of the temporal relationships of the development of the carcinoma and of Cushing's syndrome suggested that in the two cases with papillary carcinoma these conditions could have been unrelated, but that in eight of the nine cases with medullary carcinoma there was evidence that thyroid carcinoma was present at the time of diagnosis of Cushing's syndrome.

The other main groups of the so-called `non-endocrine' tumours associated with Cushing's syndrome are briefly reviewed, and evidence that a surprising number of these cases are related to carcinoid tumours is put forward. Medullary carcinoma of the thyroid is also probably related to this group of tumours. It is suggested that the great majority of the tumours associated with Cushing's syndrome are derived from cells of foregut origin which are endocrine in nature. In neoplasms derived from these cells the polypeptide hormone may well be imperfectly formed, and possess an amino-acid sequence in common with ACTH or other biologically active polypeptides.

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Selected References

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  1. Anderson E. E., Glenn J. F. Cushing's syndrome associated with anaplastic carcinoma of the thyroid gland. J Urol. 1966 Jan;95(1):1–4. doi: 10.1016/S0022-5347(17)63397-4. [DOI] [PubMed] [Google Scholar]
  2. BAGSHAWE K. D. Hypokalaemia, carcinoma and Cushing's syndrome. Lancet. 1960 Aug 6;2(7145):284–287. doi: 10.1016/s0140-6736(60)91375-1. [DOI] [PubMed] [Google Scholar]
  3. BERTHELOT P., BENHAMOU J. P., FAUVERT R. [Hypercorticism and cancer of the uterus. Study of a case and review of the literature]. Presse Med. 1961 Oct 21;69:1899–1902. [PubMed] [Google Scholar]
  4. BOURGOIGNIE J., DUPONT J. C., NOIRET R. ASSOCIATION D'UN PH'EOCHROMOCYTOME ET D'UN HYPERCORTICISME DU TYPE CUSHING AVEC HYPERALDOST'ERONURIE. Ann Endocrinol (Paris) 1964 May-Jun;25:269–284. [PubMed] [Google Scholar]
  5. BROWN H., LANE M. CUSHING'S AND MALIGNANT CARCINOID SYNDROMES FROM OVARIAN NEOPLASM. Arch Intern Med. 1965 Apr;115:490–494. doi: 10.1001/archinte.1965.03860160116021. [DOI] [PubMed] [Google Scholar]
  6. CHRISTY N. P. Adrenocorticotrophic activity in the plasma of patients with Cushing's syndrome associated with pulmonary neoplasms. Lancet. 1961 Jan 14;1(7168):85–86. doi: 10.1016/s0140-6736(61)92125-0. [DOI] [PubMed] [Google Scholar]
  7. COHEN R. B., TOLL G. D., CASTLEMAN B. Bronchial adenomas in Cushing's syndrome: their relation to thymomas and oat cell carcinomas associated with hyperadrenocorticism. Cancer. 1960 Jul-Aug;13:812–817. doi: 10.1002/1097-0142(196007/08)13:4<812::aid-cncr2820130425>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
  8. DAVIS R. B., KENNEDY B. J. Carcinoid syndrome associated with adrenal hyperplasia. Arch Intern Med. 1962 Feb;109:192–200. doi: 10.1001/archinte.1962.03620140064010. [DOI] [PubMed] [Google Scholar]
  9. DYSON B. C. Cushing's disease; report of a case associated with carcinoma of the thyroid gland and cryptococcosis. N Engl J Med. 1959 Jul 23;261(4):169–172. doi: 10.1056/NEJM195907232610403. [DOI] [PubMed] [Google Scholar]
  10. ESCOVITZ W. E., REINGOLD I. M. Functioning malignant bronchial carcinoid with Cushing's syndrome and recurrent sinus arrest. Ann Intern Med. 1961 Jun;54:1248–1259. doi: 10.7326/0003-4819-54-6-1248. [DOI] [PubMed] [Google Scholar]
  11. FALCK B., LARSON B., VON, ROSENGREN E., SVENAEUS K. ON THE PRESENCE OF A SECOND SPECIFIC CELL SYSTEM IN MAMMALIAN THYROID GLAND. Acta Physiol Scand. 1964 Dec;62:491–492. doi: 10.1111/j.1748-1716.1964.tb10449.x. [DOI] [PubMed] [Google Scholar]
  12. GOWENLOCK A. H., PLATT D. S., CAMPBELL A. C., WORMSLEY K. G. OAT-CELL CARCINOMA OF THE BRONCHUS SECRETING 5-HYDROXYTRYPTOPHAN. Lancet. 1964 Feb 8;1(7328):304–306. doi: 10.1016/s0140-6736(64)92411-0. [DOI] [PubMed] [Google Scholar]
  13. HALLWRIGHT G. P., NORTH K. A., REID J. D. PIGMENTATION AND CUSHING'S SYNDROME DUE TO MALIGNANT TUMOR OF THE PANCREAS. J Clin Endocrinol Metab. 1964 Jun;24:496–500. doi: 10.1210/jcem-24-6-496. [DOI] [PubMed] [Google Scholar]
  14. HARRISON M. T., MONTGOMERY D. A., RAMSEY A. S., ROBERTSON J. H., WELBOURN R. B. Cushing's syndrome with carcinoma of bronchus and with features suggesting carcinoid tumour. Lancet. 1957 Jan 5;272(6958):23–25. doi: 10.1016/s0140-6736(57)92437-6. [DOI] [PubMed] [Google Scholar]
  15. HOKFELT B., SJOGREN B., FALKHEDEN T. Steroid hormone production in a case of Cushing's syndrome with electrolyte changes simulating primary aldosteronism. Acta Endocrinol (Copenh) 1959 Jun;31(2):175–184. doi: 10.1530/acta.0.xxxi0175. [DOI] [PubMed] [Google Scholar]
  16. JENSEN M. K., TRANSBOL I., OLESEN K. H. CANCER OG CUSHING'S SYNDROM. FEM TILFAELDE MED OMTALE AF DE SPECIELLE KLINISKE OG LABORATORIEMAESSIGE FUND. Nord Med. 1965 Mar 4;73:197–202. [PubMed] [Google Scholar]
  17. LIDDLE G. W., ISLAND D. P., NEY R. L., NICHOLSON W. E., SHIMIZU N. Nonpituitary neoplasms and Cushing's syndrome. Ectopic "adrenocorticotropin" produced by nonpituitary neoplasms as a cause of Cushing's syndrome. Arch Intern Med. 1963 Apr;111:471–475. doi: 10.1001/archinte.1963.03620280071011. [DOI] [PubMed] [Google Scholar]
  18. MEADOR C. K., LIDDLE G. W., ISLAND D. P., NICHOLSON W. E., LUCAS C. P., NUCKTON J. G., LUETSCHER J. A. Cause of Cushing's syndrome in patients with tumors arising from "nonendocrine" tissue. J Clin Endocrinol Metab. 1962 Jul;22:693–703. doi: 10.1210/jcem-22-7-693. [DOI] [PubMed] [Google Scholar]
  19. Mirouze J., Jaffiol C., Badach L., Saade F., Bernard R. Syndrome de Cushing avec hypercortisolisme pur pseudo-tumoral révélateur d'un cancer thyroïdien latent. Ann Endocrinol (Paris) 1965 May-Jun;26(3):300–307. [PubMed] [Google Scholar]
  20. Morse W. I., Kerenyi N., Nelson D. H. Prolonged hyperadrenocorticotrophism and pigmentation associated with bronchial carcinoid tumour. Can Med Assoc J. 1967 Jan 14;96(2):104–109. [PMC free article] [PubMed] [Google Scholar]
  21. O'Riordan J. L., Blanshard G. P., Moxham A., Nabarro J. D. Corticotrophin-secreting carcinomas. Q J Med. 1966 Apr;35(138):137–147. [PubMed] [Google Scholar]
  22. OATES J. A., MELMON K., SJOERDSMA A., GILLESPIE L., MASON D. T. RELEASE OF A KININ PEPTIDE IN THE CARCINOID SYNDROME. Lancet. 1964 Mar 7;1(7332):514–517. doi: 10.1016/s0140-6736(64)92907-1. [DOI] [PubMed] [Google Scholar]
  23. PRUNTY F. T., BROOKS R. V., DUPRE J., GIMLETTE T. M., HUTCHINSON J. S., MCSWINEY R. R., MILLS I. H. ADRENOCORTICAL HYPERFUNCTION AND POTASSIUM METABOLISM IN PATIENTS WITH "NON- ENDOCRINE" TUMORS AND CUSHING'S SYNDROME. J Clin Endocrinol Metab. 1963 Aug;23:737–746. doi: 10.1210/jcem-23-8-737. [DOI] [PubMed] [Google Scholar]
  24. PRUNTY F. T. SUCCESSFUL TREATMENT OF CUSHING'S SYNDROME SECONDARY TO AN ARGENTAFFINOMA BY BILATERAL ADRENALECTOMY. Proc R Soc Med. 1965 Aug;58:573–575. doi: 10.1177/003591576505800802. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Petersen H. W., Gorry J. D., Rupp J. J. Reversible Cushing's syndrome caused by a bronchial adenoma. South Med J. 1967 Feb;60(2):138–passim. doi: 10.1097/00007611-196702000-00007. [DOI] [PubMed] [Google Scholar]
  26. RIGGS B. L., Jr, SPRAGUE R. G. Association of Cushing's syndrome and neoplastic disease: observations in 232 cases of Cushing's syndrome and review of the literature. Arch Intern Med. 1961 Dec;108:841–849. doi: 10.1001/archinte.1961.03620120025005. [DOI] [PubMed] [Google Scholar]
  27. Roberts P. A. Carcinoma of the Thyroid, Hypoparathyroidism and Cushing's Syndrome. Proc R Soc Med. 1962 Sep;55(9):805–806. doi: 10.1177/003591576205500918. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. SAYLE B. A., LANG P. A., GREEN W. O., Jr, BOSWORTH W. C., GREGORY R. CUSHING'S SYNDROME DUE TO ISLET CELL CARCINOMA OF THE PANCREAS. REPORT OF TWO CASES: ONE WITH ELEVATED 5-HYDROXYINDOLE ACETIC ACID AND COMPLICATED BY ASPERGILLOSIS. Ann Intern Med. 1965 Jul;63:58–68. doi: 10.7326/0003-4819-63-1-58. [DOI] [PubMed] [Google Scholar]
  29. SOBOTA J. T., REED R. J. MULTIPLE BRONCHIAL ADENOMAS, CUSHING'S SYNDROME AND HYPOKALEMIC ALKALOSIS. REPORT OF A CASE. Dis Chest. 1964 Sep;46:367–371. doi: 10.1378/chest.46.3.367. [DOI] [PubMed] [Google Scholar]
  30. THORNE M. G. Cushing's syndrome associated with bronchial carcinoma; an enquiry into the relationship of this syndrome to neoplastic disease. Guys Hosp Rep. 1952;101(4):251–272. [PubMed] [Google Scholar]
  31. WILLIAMS E. D. A REVIEW OF 17 CASES OF CARCINOMA OF THE THYROID AND PHAEOCHROMOCYTOMA. J Clin Pathol. 1965 May;18:288–292. doi: 10.1136/jcp.18.3.288. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. WILLIAMS E. D., SANDLER M. The classification of carcinoid tum ours. Lancet. 1963 Feb 2;1(7275):238–239. doi: 10.1016/s0140-6736(63)90951-6. [DOI] [PubMed] [Google Scholar]
  33. Williams E. D., Brown C. L., Doniach I. Pathological and clinical findings in a series of 67 cases of medullary carcinoma of the thyroid. J Clin Pathol. 1966 Mar;19(2):103–113. doi: 10.1136/jcp.19.2.103. [DOI] [PMC free article] [PubMed] [Google Scholar]

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