case-presentation_96

Problem list:

• Cushing syndrome ( ACTH dependent)
• Total thyroidectomy….. MTC
• Positive RET proto-oncogene (codon 634)
•  Adrenal mass
• Family Hx: MTC and MEN2A

DDx:

• Classical MEN2A and Cushing Sx (ACTH dependent) due to MTC
•  Classical MEN2A and Cushing Sx( ACTH dependent) due to pheochromocytoma)
•  FMTC and Cushing Sx (ACTH dependent) due to MTC and non- functional adrenal tumor(incidentaloma)
•  MEN2A + Cushing disease

• What is correlation between RET proto-oncogene and variants of      MEN2 ?
• What is possibility of pheochromocytoma and hyperparathyroidism in the patient?
•  What is possibility of ectopic Cushing in MTC or pheochromocytoma?
•  What is treatment and what should be done in this case ?