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2000
Volume 25, Issue 4
  • ISSN: 1871-5303
  • E-ISSN: 2212-3873

Abstract

Introduction

Neuroendocrine tumors (NETs) exhibit a wide range of clinical presentations, including the production of various hormones. Calcitonin, a sensitive marker for medullary thyroid cancer (MTC), is nonspecific and may be elevated in extra-thyroidal NETs.

Case Presentation

We present the case of a 64-year-old female patient who underwent total thyroidectomy due to a nodule in the isthmus, with a fine-needle aspiration biopsy indicating follicular neoplasia. Pathological examination revealed macro- and micro-nodular thyroid hyperplasia, along with a parathyroid adenoma. During postoperative follow-up, a progressive elevation of calcitonin was observed, reaching 64.2 pg/ml, while carcinoembryonic antigen levels remained normal. Since no MTC foci were found upon reviewing the thyroidectomy specimen, an investigation into the origin of the elevated calcitonin was initiated. Serum chromogranin A and specific neuronal enolase levels were within normal ranges. Tc-99m HYNIC-TOC scintigraphy yielded negative results. Additionally, an upper gastrointestinal endoscopy revealed a submucosal lesion in the second portion of the duodenum, with a biopsy confirming a grade 1 NET. The patient underwent Whipple surgery and hepatic metastasectomy. Postoperatively, a decrease in baseline serum calcitonin levels was observed. Seven years after surgery, she continues specialized monitoring with no biochemical or imaging evidence of disease.

Conclusion

Serum calcitonin contributes to the diagnosis and monitoring of anterior intestine NETs.

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References

  1. RizenE.N. PhanA.T. Neuroendocrine tumors: A relevant clinical update.Curr. Oncol. Rep.202224670371410.1007/s11912‑022‑01217‑z 35254612
    [Google Scholar]
  2. CarrilloD. Muñoz-MedelM. RetamalI. PintoM. BravoM.L. NerviB. PeñaJ. ValenzuelaY. GuardaF.J. NiloF. BelloF. OrellanaP. VicentiniD. QuintanaJ.C. TorresP.J. LealJ.L. GarridoM. Tumores neuroendocrinos: Un desafío transversal.Rev. Med. Chil.2021149688889810.4067/s0034‑98872021000600888 34751348
    [Google Scholar]
  3. PavelM. ÖbergK. FalconiM. KrenningE.P. SundinA. PerrenA. BerrutiA. Gastroenteropancreatic neuroendocrine neoplasms: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.Ann. Oncol.202031784486010.1016/j.annonc.2020.03.304 32272208
    [Google Scholar]
  4. La RosaS. UccellaS. Classification of neuroendocrine neoplasms: Lights and shadows.Rev. Endocr. Metab. Disord.202122352753810.1007/s11154‑020‑09612‑2 33169199
    [Google Scholar]
  5. SansoneA. LaurettaR. VottariS. ChiefariA. BarnabeiA. RomanelliF. AppetecchiaM. Specific and non-specific biomarkers in neuroendocrine gastroenteropancreatic tumors.Cancers (Basel)2019118111310.3390/cancers11081113 31382663
    [Google Scholar]
  6. RindiG. MeteO. UccellaS. BasturkO. La RosaS. BrosensL.A.A. EzzatS. de HerderW.W. KlimstraD.S. PapottiM. AsaS.L. Overview of the 2022 WHO classification of neuroendocrine neoplasms.Endocr. Pathol.202233111515410.1007/s12022‑022‑09708‑2 35294740
    [Google Scholar]
  7. SchneiderR. WaldmannJ. SwaidZ. RamaswamyA. FendrichV. BartschD.K. SchlosserK. Calcitonin-secreting pancreatic endocrine tumors: Systematic analysis of a rare tumor entity.Pancreas201140221322110.1097/MPA.0b013e3182015f5d 21178652
    [Google Scholar]
  8. d’HerbomezM. Calcitonin: Indications and Interpretation.FrancePresse Medicale19831141
    [Google Scholar]
  9. UccellaS. BlankA. MaraglianoR. SessaF. PerrenA. La RosaS. Calcitonin-producing neuroendocrine neoplasms of the pancreas: Clinicopathological study of 25 cases and review of the literature.Endocr. Pathol.201728435136110.1007/s12022‑017‑9505‑4 29063495
    [Google Scholar]
  10. CvijovicG. MicicD. KendereskiA. ZoricS. Sumarac-DumanovicM. TaticS. TrivicA. Pejkovic-StamenkovicD. JeremicD. Ectopic calcitonin secretion in a woman with large cell neuroendocrine lung carcinoma.Hormones (Athens)201312458459010.14310/horm.2002.1447 24457407
    [Google Scholar]
  11. GiannettaE. GianfrilliD. PozzaC. LaurettaR. GraziadioC. SbardellaE. BaroliA. CaronnaR. ChirlettiP. LenziA. IsidoriA.M. Extrathyroidal calcitonin secreting tumors.Medicine (Baltimore)2016953e241910.1097/MD.0000000000002419 26817871
    [Google Scholar]
  12. LaBryerL. SawhR. McLaurinC. ScofieldR.H. Calcitonin-secreting neuroendocrine carcinoma of larynx with metastasis to thyroid.Case Rep. Endocrinol.201520151610.1155/2015/606389 26491576
    [Google Scholar]
  13. NozièresC. ChardonL. GoichotB. Borson-ChazotF. HervieuV. ChikhK. Lombard-BohasC. WalterT. Neuroendocrine tumors producing calcitonin: Characteristics, prognosis and potential interest of calcitonin monitoring during follow-up.Eur. J. Endocrinol.2016174333534110.1530/EJE‑15‑0917 26671974
    [Google Scholar]
  14. KiriakopoulosA. GiannakisP. MenenakosE. Calcitonin: Current concepts and differential diagnosis.Ther. Adv. Endocrinol. Metab.20221310.1177/20420188221099344 35614985
    [Google Scholar]
  15. GiannettaE. GuarnottaV. AltieriB. SciammarellaC. GuadagnoE. MalandrinoP. PulianiG. FeolaT. IsidoriA.M. ColaoA.A.L. FaggianoA. Endocrine Tumours: Calcitonin in thyroid and extra-thyroid neuroendocrine neoplasms: The two-faced Janus.Eur. J. Endocrinol.20201836R197R21510.1530/EJE‑20‑0506 33112280
    [Google Scholar]
  16. KováčováM. FilkováM. PotočárováM. KiňováS. PajvaniU.B. Calcitonin-secreting pancreatic neuroendocrine tumors: A case report and review of the literature.Endocr. Pract.2014208e140e14410.4158/EP13505.CR 24793921
    [Google Scholar]
  17. KonT. WadaR. SuzukiR. NakayamaY. EbinaY. YagihashiS. VIP and calcitonin-producing pancreatic neuroendocrine tumor with watery diarrhea: Clinicopathological features and the effect of somatostatin analogue.JOP2012132226230 22406608
    [Google Scholar]
  18. LaroucheV. AkirovA. AlshehriS. EzzatS. Management of small bowel neuroendocrine tumors.Cancers (Basel)2019119139510.3390/cancers11091395 31540509
    [Google Scholar]
  19. PerrenA. CouvelardA. ScoazecJ.Y. CostaF. BorbathI. Delle FaveG. GorbounovaV. GrossD. GrossmanA. JensenR.T. KulkeM. ObergK. RindiG. SorbyeH. WelinS. ENETS consensus guidelines for the standards of care in neuroendocrine tumors: Pathology - diagnosis and prognostic stratification.Neuroendocrinology2017105319620010.1159/000457956 28190015
    [Google Scholar]
  20. HuguetI. LamasC. VeraR. LomasA. QuilezR.P. GrossmanA. BotellaF. Medullary thyroid carcinoma and duodenal calcitonin-secreting neuroendocrine tumour: More than coincidence?Endocrinol. Diabetes Metab. Case Rep.2013201313002110.1530/EDM‑13‑0021 24616764
    [Google Scholar]
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