[A case of MEN IIA variant associated with ectopic ACTH production and mammary carcinoma].

A 69-year-old house wife admitted to our hospital with complaints of fever, drowsiness, watery diarrhea and uncontrolled blood sugar level. She had been operated for the right mammary carcinoma 11 years ago. Left adrenal mass and nodules in the thyroid gland were discovered by CT and hypersecretion of adrenocortical hormone, catecholamine and PTH as well as ectopic ACTH production were indicated endocrinologically. Autopsy and histopathological examination revealed left adrenal pheochromecytoma associated with bilateral adrenocortical hypertrophy, adenomas in 2 of 5 parathyroid glands and papillary thyroid carcinoma with adenomatous goiter. Ectopic ACTH production was identified immunohistochemically in the pheochromecytoma. This case is a rare variant of non-familial MEN (multiple endocrine neoplasm) type IIA with ectopic ACTH production and metachronous mammary carcinoma.