Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We present 2 patients with pituitary metastases from thyroid carcinoma-the first from anaplastic thyroid carcinoma and the second from follicular thyroid carcinoma. The first patient, a 50-year-old lady, presented with 2-week history of hoarseness of voice, dysphagia, dyspnoea, and neck swelling. Imaging revealed metastatic thyroid cancer to lymph nodes and bone. Histology from surgery confirmed anaplastic thyroid cancer. She was found to have pituitary metastases postoperatively when she presented with nonvertiginous dizziness. She subsequently underwent radiotherapy and radioiodine treatment but passed away from complications. The second patient, a 65-year-old lady, presented with loss of appetite and weight with increased goitre size and dyspnoea. Surgery was performed in view of compressive symptoms and histology confirmed follicular thyroid carcinoma. Imaging revealed metastases to bone, lung, and pituitary. She also had panhypopituitarism with hyperprolactinemia and diabetes insipidus. She received radioiodine therapy but eventually passed away from complications.
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PMID:Thyroid carcinoma with pituitary metastases: 2 case reports and literature review. 2568 65

A 56-year-old male patient with papillary thyroid carcinoma was given radioiodine for the treatment of persistent disease. Post radioiodine whole body scan revealed uptake at the thyroidal region and bilateral uptake at the upper thoracic region. Single photon emission computed tomography/computed tomography (SPECT/CT) confirmed uptake at the left thyroid lobe, and additional symmetrical mammary gland uptake was observed at both breasts. The patient had obesity-related gynecomastia, but he did not have any history of breast cancer, mastitis, hyperprolactinemia, or galactorrhea. Although breast uptake of radioiodine is a common finding in postpartum or lactating women, it is uncommon in male patients. To our knowledge, this is the first case of a male patient with breast uptake of radioiodine documented with SPECT/CT. SPECT/CT is useful in male patients in the differentiation of benign breast uptake with lung metastases or axillary metastases of thyroid cancer.
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PMID:Bilateral breast uptake of radioiodine in a male patient with gynecomastia: A case report. 2643 Mar 22

This is the first reported case of pineal lymphoma with concomitant prolactin-producing pituitary adenoma.A 51-year-old male experienced worsening headaches accompanied by nausea, diplopia, and memory loss for 1 month. Cranial nerve examination revealed bilateral upward gaze limitation with convergence impairment, which is known as Parinaud syndrome. Magnetic resonance images revealed a mass in the pineal gland with a coexisting mass within the enlarged sella fossa. Hormone analysis revealed hyperprolactinemia. The pineal mass was removed without injuring the hypothalamus, brain stem, or any neighboring vessels. Pathology examination confirmed the diagnosis of diffuse large B-cell lymphoma (DLBCL) involving the pineal gland. After further studies, the pineal lymphoma was determined to be a secondary tumor from a gastric primary tumor. The patient died 6 months after diagnosis due to systemic progression of DLBCL.Although the mechanistic link between hyperprolactinemia and lymphoma progression has not been clarified on a clinical basis, high prolactin levels may contribute to the rapid progression and therapeutic resistance of the lymphoma.
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PMID:Pineal Diffuse Large B-Cell Lymphoma Concomitant With Pituitary Prolactinoma: Possible Correlation Between 2 Distinguished Pathologies: A Case Report. 2693 37

Pituitary adrenocorticotropic hormone-dependent Cushing's syndrome due to ectopic production of corticotropin-refeasing hormone (CRH) or bombesin (gastrin-releasing peptide) is an extremely rare cause of pituitary adrenocorticotropic hormone (ACTH) hypersecretion. We report a patient with elevated ACTH and cortisol levels due to ectopic secretion of both bombesin and CRH by metastatic medullary carcinoma of the thyroid (MCT). A 45-year-old man was investigated because of diabetes insipidus and visual field disturbances due to suprasellar metastasis of the MCT. On physical examination, he was a chronically ill man with a body mass index of 18.5 and was darkly pigmented but without other features typical of Cushing's syndrome. Hypogonadotropic hypogonadism, thyroid-stimulating hormone (TSH) deficiency, and hyperprolactinemia were due to pituitary stalk disorder, in light of these deficiencies, we were surprised to find elevated plasma ACTH, cortisol, and growth hormone (GH) levels throughout the day. Plasma ACTH at 9AM was 118 pg/ml and plasma cortisol was 859 nmol/L. At 12PM, ACTH was 89 pg/ml whereas plasma cortisol was 540 nmol/L. Urinary 17 OH CS were elevated (38 nmol/24 hr). The mean of the four-point day curve for GH was elevated. Plasma electrolytes were normal. The presence of both CRH and bombesin was documented by immunocytologic studies in the metastases (lymph node and suprasellar biopsy). ACTH was not found in any of the metastases. Because of the close proximity of the suprasellar metastasis to the portal pituitary circulation, CRH and bombesin could have been readily provided to the pituitary corticotrophs.
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PMID:Elevated adrenocorticotropic hormone and cortisol levels in a patient with medullary carcinoma of the thyroid containing ectopic immunoreactive corticotropin-releasing hormone and bombesin. 3235 21


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