Cushing syndrome due to thymic carcinoid in multiple endocrine neoplasia type 1

Characteristic presentations of MEN1 syndrome include the involvement of parathyroid glands, pancreas & pituitary. In addition to these presentations, adrenocortical lesions, carcinoids, lipoma and angiofibroma may also be seen in these patients. MEN1 could show a variety of clinical presentations in each stage of the disease. One such presentation is Cushings syndrome. Hypercortisolism in the base of MEN1 could be a result of pituitary or nonpituitary causes (adrenal & pancreatic lesions & carcinoid tumors). Thymic carcinoid is a rare malignancy. Although, 25% of all reported cases of this tumor are MEN1 related, as compared to other MEN1 related neoplasia, there is limited information on this condition. This paper describes a 44 year-old man with MEN1, an involvment of pancreas (insulinoma & gastrinoma), pituitary (prolactinoma) and hyperparathyroidism that in the progression of the disease involved in Cushing syndrome from the thymic carcinoid. This paper also reviews literature availabe on the etiology of Cushing’s syndrome.