A Rare Encounter – Papillary Thyroid Cancer Meets Cushing’s Disease Case report and literature review

Abstract

Glucocorticoids (GC) play major role in the physiologic stress response. However chronic exposure to glucocorticoids as seen in Cushing's disease (CD) has detrimental effects on multiple systems: cardiovascular, metabolic, immune, psychological. Papillary thyroid carcinoma is the most common type of thyroid cancer and the most common endocrine malignancy and its incidence has been increasing lately. However concomitant thyroid cancer with CD is uncommon.We report a case of papillary thyroid microcarcinoma (PTMC) in a woman with metabolic syndrome and multinodular goiter, diagnosed with CD due to a corticotroph pituitary microadenoma. Both CD and thyroid cancer were cured after surgery.A review of literature shown association between papillary thyroid carcinoma and Cushing's disease is very rare and so far there is no known genetic mutation to link the two neoplastic conditions. While this may be a random association, possible implications of chronic GC exposure in cancer progression are discussed.