Pseudotumor of thymus occuring after hypercorticolism recovery : casereport

S. Baki*^a (Dr), G. El Mghari^a (Pr), N. El Ansari^a (Pr)

^a Service d'Endocrinologie, Diabetologie et Maladies Metaboliques, CHU Mohamed VI, Marrakesh, MAROC

* salwabaki@gmail.com

Introduction: Cushing syndrome is due to an ectopic secreting adrenocorticotropic hormone (ACTH) in 10 % to 20% of cases. Among them, thymic tumors represent almost half of cases. It has been described that patients sometimes develop benign hyperplasia after hypercortisolism correction. Aim(s): We represent a case of a thymic tumor to enhance the awareness of this entity in order to avert diagnostic thoracotomy. Materials and methods: case report Results: A 45 y.o man was admitted in our department to manage a severe cushing's syndrome. The results of endocrine work-up were consistent with an ectopic cushing syndrome. Morphologic investigations, a computed tomography body scan and an octreoscan, has shown a 1/1.5 cm pulmonary tumor. the patient underwent a thoracic surgery. the histology revealed a carcinoid tumor with positive immunostaining for ACTH. this surgery led to a rapid remission of the hypercortisolism. However, 6 months later, a follow-up CT scan showed a triangular nodular mediastinal enlargement. Based on the fact that the cortisol and ACTH levels were normal, we have decided to not operate the patient and follow the thymic tumor progression by CT scan months later, the CT scan has shown a significant reduction in the thymic enlargementConclusion: The mechanisms of thymic hyperplasia is thought to be thymic depletion resulting for high plasmatic cortisol concentrations followed by the thymic enlargement

L’auteur n’a pas transmis de déclaration de conflit d’intérêt.