Papillary Thyroid Carcinoma, Cushing Disease, and Adrenocortical Carcinoma in a Patient with Li-Fraumeni Syndrome

Bibliographic Details
Title: Papillary Thyroid Carcinoma, Cushing Disease, and Adrenocortical Carcinoma in a Patient with Li-Fraumeni Syndrome
Authors: Jared G. Friedman, MD, Ioannis G. Papagiannis, MD, FACE
Source: AACE Clinical Case Reports, Vol 10, Iss 4, Pp 127-131 (2024)
Publisher Information: Elsevier, 2024.
Publication Year: 2024
Collection: LCC:Diseases of the endocrine glands. Clinical endocrinology
Subject Terms: Li-Fraumeni syndrome, p53, adrenocortical carcinoma, endocrine neoplasia, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
More Details: Background/Objective: Li-Fraumeni syndrome (LFS) is an inherited sequence variant in TP53 characterized by the early onset of various core malignancies including adrenocortical carcinoma (ACC), sarcomas, breast cancer, leukemias, and central nervous system tumors. We present a case of a patient with LFS who developed endocrine neoplasms not classically seen in LFS in addition to developing ACC. Case Report: A 26-year-old nonbinary individual assigned female at birth with a history of LFS complicated by osteosarcoma of the jaw was incidentally found to have thyroid and sellar masses on surveillance magnetic resonance imaging. Fine-needle aspiration of thyroid mass confirmed papillary thyroid carcinoma, and the patient underwent total thyroidectomy. Pituitary workup was notable for laboratory test results consistent with adrenocorticotropic hormone-dependent hypercortisolism; the patient underwent resection of the pituitary lesion. The patient was subsequently noted on abdominal imaging to have a new left adrenal mass; they underwent left adrenalectomy with pathology consistent with ACC. Discussion: There is limited literature on the relationship between LFS and thyroid and pituitary neoplasms. Genetic testing has suggested that TP53 sequence variants may play a role in tumorigenesis in thyroid and pituitary neoplasms; however, most of the current literature is based on evidence of somatic rather than germline sequence variants. Conclusion: This case highlights a patient with LFS with neoplasia of multiple endocrine organs including ACC, which is a classic finding, as well as papillary thyroid carcinoma and Cushing disease. Further investigation may be necessary to assess if patients with LFS are at a higher risk of various endocrine neoplasms in addition to the core malignancies classically described because this could affect future screening protocols.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2376-0605
Relation: http://www.sciencedirect.com/science/article/pii/S2376060524000312; https://doaj.org/toc/2376-0605
DOI: 10.1016/j.aace.2024.03.007
Access URL: https://doaj.org/article/b29b5ec177ef4bb7bf9dc8d5c76fd8e8
Accession Number: edsdoj.b29b5ec177ef4bb7bf9dc8d5c76fd8e8
Database: Directory of Open Access Journals
More Details
ISSN:23760605
DOI:10.1016/j.aace.2024.03.007
Published in:AACE Clinical Case Reports
Language:English