Endocrinology and Metabolism

Case Reports

A Case of Cushing's Disease with Renal Cell Carcinomaand End-stage Renal Disease.: Jang Eun Lee, Ik Jun Choi, Young Jai Park, Hyo Jin Lee, Kyoung Hwan Lee, Seung Hyun Ko, Ki Ho Song, Yu Bai Ahn; J Korean Endocr Soc. 2007;22(1):62-67. Published online February 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.1.62

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Abstract PDF: Cushing's disease is the most common cause of endogenous Cushing's syndrome caused by the excessive secretion of adrenocorticotropic hormone (ACTH) by pituitary ACTH-secreting tumors. The tumors are usually microadenomas (< 10 mm in diameter). Macroadenomas are rare, and corticotroph hyperplasia and carcinomas are extremely rare. Patients with these tumors exhibit an increase in plasma ACTH and cortisol levels, elevated urinary excretion of cortisol and adrenocortical steroid metabolites, evidence of altered negative feedback of cortisol and disturbances in neuroendocrine regulation. The diagnosis of Cushing's disease can be challenging in patients with renal failure the presence of abnormal plasma cortisol, poor gastrointestinal tract absorption of dexamethasone and altered functioning of the hypophyseal-pituitary-adrenal axis have been reported in end-stage renal disease, and the urinary cortisol increment method is not reliable in these patients. The prevalence of renal cell carcinoma in patients on dialysis is higher than in the general population. We recently treated a patient with Cushing's disease and end-stage renal disease as a result of renal cell carcinoma. The diagnosis was made by laboratory evaluation of plasma and radiological examination. Here we report a case of Cushing's disease with a review of the medical literature.

A Case of Papillary Thyroid Carcinoma Combined with Metastatic Renal Cell Carcinoma in the Thyroid.: Kang Il Cheon, Kyung Wook Lee, Ji Oh Mok, Yeo Ju Kim, Hyung Kyu Park, Chul Hee Kim, Sang Jin Kim, Dong Won Byun, Kyo Il Suh, Myung Hi Yoo, Hee Kyung Kim, Youn Woo Ko; J Korean Endocr Soc. 2006;21(1):85-89. Published online February 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.1.85

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Metastasis to the thyroid from distant cancer is rarely diagnosed clinically and renal cell carcinoma is the most common group of neoplasm to metastasize to the thyroid. Papillary thyroid carcinoma is known as the most frequent primary thyroid cancer. But coexistence with metastatic renal cell carcinoma to thyroid and papillary thyroid carcinoma is very rare. We are reporting this highly unusual case of metastatic renal cell carcinoma to thyroid, which harbored papillary thyroid cancer. To our knowledge, this is the first case reported in Korea. A 57-year-old woman presented with hoarseness and palpable anterior neck mass. She had a history of renal cell carcinoma of right kidney, which had been resected 10 years previously and had undergone lower anterior resection due to sigmoid colon cancer 2 months before. Fine needle aspiration cytology suggested follicular neoplasm, and total thyroidectomy was performed. The pathology from the thyroid nodules showed papillary thyroid cancer combined metastatic renal cell carcinoma.

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A Case of Metastatic Renal Cell Carcinoma to Thyroid Gland Mimicking as Anaplastic Thyroid Carcinoma
Sooyeon Jo, Hyung Gyun Na, Chang Hoon Bae, Yoon Seok Choi
Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2021; 64(10): 755. CrossRef

A Case of Renal Cell Carcinoma with Thyroid Metastasis.: Hye Seung Jung, Young Joo Park, Hee Sun Chung, Mee Soo Chang, Tae Hoon Jin, Cheol Soo Choi, Sung Woo Park, Tae Young Kim, Do Joon Park, Bo Youn Cho; J Korean Endocr Soc. 2003;18(3):318-324. Published online June 1, 2003

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Abstract PDF: Metastatic thyroid cancer is uncommon but must be distinguished from primary thyroid cancer because of the differences in management and prognosis. Although renal cell carcinoma is one of the most common tumors that metastasize to the thyroid gland, such a case has never been reported in Korea. We describe the first case of metastatic renal cell carcinoma in the thyroid gland. A 66-year-old man presented with a neck mass detected about 6 weeks previously. He had undergone left nephrectomy due to renal cell carcinoma 8 years before and had remained disease-free thereafter. Computed tomography of the neck showed a 5 cm-sized thyroid mass. Fine needle aspiration cytology revealed some malignant cells containing intranuclear inclusions which were assumed to be papillary thyroid carcinoma. The patient underwent total thyroidectomy. Histologic diagnosis of the thyroid mass was metastatic renal cell carcinoma and further evaluation with chest computed tomography showed two enlarged mediastinal lymph nodes suggesting metastases. The previous history of malignancy should be scrutinized when managing a thyroid mass in patients with a prior or concomitant malignancy, and the possibility of metastasis should be carefully considered.

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