Acth and Calcitonin Secreting Medullary Carcinoma of the Thyroid

Abstract

SUMMARY The present report describes the case history of a woman suffering from an ectopic ACTH syndrome due to a medullary carcinoma of the thyroid. Histologic and electron microscopic studies revealed the tumorous nature of the so‐called ‘macrophage‐like’cell; the diagnostic significance of this cell is stressed. It appears that there is a whole spectrum of tumour cells ranging from the typical tumour cell via transitional forms to ‘macrophage‐like’tumour cells. Tumour tissue was investigated for the presence of calcitonin and ACTH by immunological and biological methods. Tumour tissue sections stained specifically for calcitonin in the immunofluorescence technique; high concentrations of calcitonin could be demonstrated in tumour extracts both by radioimmunoassay and bioassay. In contrast, the presence of ACTH in tumour tissue could be demonstrated only by radioimmunoassay. The negative results of the bioassay could be attributed to the relative insensitivity of the method used, and a similar explanation may account for the negative results using the immunofluorescence technique. Plasma levels of both calcitonin and ACTH were very high. A final diagnosis of an ACTH and calcitonin secreting medullary carcinoma of the thyroid was made. There is no reason to believe that these polypeptide hormones are produced by different cell types.

Radioimmunoassay of Plasma Adrenocorticotrophin in Cushing's Syndrome

“…Various aspects have been described previously (Croughs, 1970;Croughs & Docter, 1971;Croughs, Eastham, Hackeng, Schopman, Feltkamp-Vroom, Dolman & Hennemann, 1972;Croughs, Hulsmans, Israel, Hackeng & Schopman, 1972;Croughs, Docter & de Jong, 1973). The following investigations were carried out in patients with Cushing's syndrome and in normal subjects or control subjects con¬ valescing from non-endocrinological conditions.…”

Establishment and characterization of a cell line (IGSK-3) secreting human chorionic gonadotropin, adrenocorticotropic hormone and parathyroid hormone-related protein derived from primary poorly differentiated adenocarcinoma of the stomach

“…This is the first paper on the establishment of a human gastric cell line which secretes hCG, ACTH and PTHrP, and whose cells express epidermal growth factor receptor. For example, ectopic ACTH secretion is often detected in various carcinomas, such as small‐cell carcinoma (SCC) of lung, 17–19 uterine cervix and ovary, 20,21 medullary carcinoma of the thyroid and oat cell carcinoma of the urinary bladder and often causes Cushing's syndrome with amenorrhea in women, 20,22,23 osteoporosis, moon face, trunk adiposis, hypertension and so on. In this case, Cushing's syndrome was not found.…”

Osteoblastic metastases from medullary carcinoma of the thyroid

“…This neoplasm constitutes 4-12% of all thyroid malignancies (Ljungberg, 1972). The tumour is characterized by slow growth and an early development of local spread and distant metastases, and by the secretion of thyrocalcitonin (TCT) and other biologically active substances (Tashjian and Melvin, 1968;Williams et al, 1968;Bernier et 1969; Baylin et al, 1972;Croughs et al, 1972;Melvin, 1974;Birkenhager et al, 1976;Shimaoka et al, 1980). More recently, CEA (carcinoembryonic antigen) is reported to be produced by this cancer (Ishikawa and Hamada, 1976;Hamada and Hamada, 1977).…”