MEN TYPE-1 ASSOCIATED WITH MEDIASTINAL CARCINOID PRODUCING PARATHYROID-HORMONE, CALCITONIN AND CHORIONIC-GONADOTROPIN

A 34-year-old Japanese woman was admitted to our hospital with a media stinal tumor. Laboratory data showed high levels of calcitonin (CT), h uman chorionic gonadotropin (hCG) and parathyroid hormone (PTH) in the serum. Surgery was performed, but the tumor could not be completely r esected. The patient died in the 10th postoperative month due to syste mic metastasis and cachexia. At autopsy, diffuse parathyroid hyperplas ia and multiple islet cell tumors of the pancreas were found. A pathol ogical diagnosis of multiple endocrine neoplasia (MEN) type 1 associat ed with mediastinal atypical carcinoid tumor was made. Immunohistochem ical study indicated the tumor cells of the mediastinum to be positive ly stained for hCGbeta but not for PTH or CT. The tumor tissue contain ed significantly high levels of CT, PTH and whole hCG. This is the fir st case report on MEN type 1 associated with mediastinal carcinoid tum or producing PTH, CT and hCGbeta.