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Diabetes insipidus and panhypopituitarism due to intrasellar metastasis from medullary thyroid cancer


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From http://www3.interscience.wiley.com/journal...=1&SRETRY=0

 

Case Report

Diabetes insipidus and panhypopituitarism due to intrasellar metastasis from medullary thyroid cancer

 

Libero Santarpia, MD, PhD 1, Robert F. Gagel, MD 1, Steven I. Sherman, MD 1, Nicholas J. Sarlis, MD, PhD 1 a, Douglas B. Evans, MD 2, Ana O. Hoff, MD 1 * b

1Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas M. D. Anderson Cancer Center, Houston, Texas

2Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas

email: Ana O. Hoff (ana.hoff@fleury.com.br)

 

*Correspondence to Ana O. Hoff, Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas M. D. Anderson Cancer Center, Houston, Texas

 

aCurrent address: Department of Medical Affairs, Oncology U.S., Sanofi-Aventis, Bridgewater, New Jersey, USA

 

bCurrent address: Fleury Medicine & Health, S?o Paulo, SP, Brazil

Dr. Sherman has reported a financial interest/relationship with Astra Zeneca, in the form of research support and a consulting arrangement; Exelixis, in the form of a consulting arrangement; and Eisai, in the form of a consulting arrangement.

 

Editor(s) for this article:

Eben L. Rosenthal, MD

 

Keywords

MEN2B ? medullary thyroid cancer ? pituitary metastases ? diabetes insipidus ? panhypopituitarism ? calcitonin ? CEA

 

Abstract

Background.

Medullary thyroid cancer (MTC) commonly metastasizes to lymph nodes in the central and lateral neck, but spread to distant organs also occurs, typically involving lung, liver, and bone. Metastases to pituitary gland are rare for this tumor.

 

Methods.

We describe an unusual case and peculiar presentation of pituitary metastasis from MTC. We report clinical, genetic, and laboratory data of this patient.

 

Results.

A young woman with multiple endocrine neoplasia type 2B was seen with recent onset of classic symptoms and signs of panhypopituitarism, mild diabetes insipidus, and optic chiasmatic compression. Transphenoidal resection of an intrapituitary mass confirmed the presence of metastatic MTC.

 

Conclusions.

MTC recurrence may present solely with subacute pituitary symptomatology, even in the context of a very lengthy interval after initial surgery, atypically low calcitonin plasma levels, carcinoembryonic antigen doubling times, and the concomitant absence of other tell-tale signs of disseminated metastatic disease.

 

? 2008 Wiley Periodicals, Inc. Head Neck, 2008

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Thanks Mary.

 

This kind of scares me, because I have seven growths on my thyroid (in addition to changing pit MRIs). None have been biopsied, which I think is very weird and disconcerting.

 

Why does thyroid cancer "look" like - goiter? cysts? lesions?

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