A case of cushing's disease and multiple myeloma.

Abstract

A 55-year-old female of Cushing's disease associated with multiple myeloma is reported. The association of the two diseases has not been previously noted. Elevated cortisol level was controlled successfully by low doses of adrenocorticolytic agent, o,p'-DDD. However, the exacerbation of multiple myelomawas found to accompanythe serum cortisol normalization. Previous reports have shown the good efficacy of combination therapy with melphalan and prednisolone for multiple myeloma. It was suggested that the decrease of endogenous cortisol level might exacerbate the patient's multiple myeloma.

Multiple myeloma concealed by adrenal Cushing syndrome: a case report and review of the literature

“…A literature review revealed that only two cases of MM with CS had been reported; in our case, however, there were some marked differences in the clinical manifestations compared with those reports [ 5 , 6 ]. Table 2 tabulates the previously published series of MM concomitant with CS.…”

“…Kinugawa et al reported a case of Cushing disease (CD) and MM [ 5 ]. The clinical features were a rounded face, central obesity, and hypertension, so CS was suspected.…”

“…Treatment consideration varied by case. With the first, the patient was treated initially for hypercortisolemia [ 5 ]. Although surgical resection of a pituitary adenoma is conventionally the first-line therapy of CD, the patient was treated with mitotane (also known as o,p’-DDD) in accordance with her preferences.…”

Cushing's syndrome can precipitate diabetes but mask non‐Hodgkin's lymphoma

“…We speculate that lymphoma progression was suppressed by the coexistent steroid‐producing adrenal tumour. The decision to treat the non‐Hodgkin's lymphoma was, in part, based on reports of progression of haematological disease following treatment of Cushing's syndrome 1 , 2 . Although histopathological examination of the tumour revealed some features suggestive of adrenocortical carcinoma, the distinction between adenoma and carcinoma can be difficult.…”