[Medullary carcinoma of the thyroid gland with Cushing's syndrome]

The authors describe generalized medullary carcinoma of the thyroid gland with a typical slow 23-year progression which due to prolonged hypercortisolism led to the development of classical "paraneoplastic" Cushing's syndrome. The authors describe the diagnostic difficulties as regards laboratory tests. The case confirms not only the need of early radical treatment of these carcinomas which is the optimal solution, which however can be implemented only in exceptional instances, but also of the detection of this syndrome in all patients with medullary carcinoma of the thyroid in the preclinical stage. Clinically developed Cushing's syndrome or hypokalaemic alkalosis are in the majority of cases a late symptom associated as a rule with advanced generalization of this carcinoma.