A case of Cushing's disease and multiple myeloma

Multiple myeloma concealed by adrenal Cushing syndrome: a case report and review of the literature

Background

Cushing syndrome coexisting with multiple myeloma has been previously described in a few reports. Overlapping clinical manifestations can lead to misdiagnoses.

Case presentation

We presented an extremely rare case of a 33-year-old Thai woman with concomitant kappa light chain myeloma with adrenal Cushing syndrome, both of which were related to skeletal manifestations. A precedence report indicated that treatment of the Cushing syndrome could exacerbate the myeloma symptoms. Therefore, we were faced with the dilemma of which disease should be addressed first. We decided to treat our patient with a combination chemotherapy followed by an autologous stem cell transplant. Subsequently, a left laparoscopic adrenalectomy was successfully undertaken.

Conclusion

We have reported the first association between adrenocorticotropic hormone-independent Cushing syndrome resulting from a left autonomous cortisol-secreting adrenal adenoma, and multiple myeloma.

Electronic supplementary material

The online version of this article (10.1186/s13256-018-1731-y) contains supplementary material, which is available to authorized users.

Suppression of Hodgkin's disease in a patient with Cushing's syndrome

Hodgkin's disease, one of the more common tumors in pediatric oncology, has been shown to be highly responsive to steroids in conjunction with other chemotherapy agents. The authors describe a patient with Cushing's syndrome that suppressed his Hodgkin's disease. He developed constitutional symptoms, and his Hodgkin's disease progressed after the removal of his pituitary tumor. The patient is disease-free following ABVD/MOPP chemotherapy. A high level of steroids before treatment, albeit endogenous, did not preclude successful treatment of Hodgkin's disease. The effect of Cushing's syndrome on Hodgkin's disease has not been previously reported.