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Case Reports
. 2016 Jan;95(3):e2419.
doi: 10.1097/MD.0000000000002419.

Extrathyroidal Calcitonin Secreting Tumors: Pancreatic Neuroendocrine Tumors in Patients With Multinodular Goiter: Two Case Reports

Elisa Giannetta  1 , Daniele Gianfrilli, Carlotta Pozza, Rosa Lauretta, Chiara Graziadio, Emilia Sbardella, Alberto Baroli, Roberto Caronna, Piero Chirletti, Andrea Lenzi, Andrea M Isidori
Affiliations
Case Reports

Extrathyroidal Calcitonin Secreting Tumors: Pancreatic Neuroendocrine Tumors in Patients With Multinodular Goiter: Two Case Reports

Elisa Giannetta et al. Medicine (Baltimore). 2016 Jan.

Abstract

Calcitonin is the hallmark of medullary thyroid carcinoma. However, extrathyroidal neuroendocrine tumors can also release calcitonin.We report 2 cases of calcitonin-secreting pancreatic tumors found in asymptomatic patients with thyroid nodules referred to our center within 11 months.Case 1: A man initially referred for thyroid nodule characterization was found to have hypercalcitoninemia (>200 pg/mL) during non-neoplastic fine-needle aspiration.Case 2: A woman evaluated for liver metastasis was found to have hypercalcitoninemia and multinodular goiter.Our research emphasizes that marked hypercalcitoninemia in the presence of thyroid nodules is not necessarily due to medullary thyroid carcinoma; awareness of this could avoid unnecessary thyroidectomy. The lack of specific symptoms related to hypercalcitoninemia may be the reason that the prevalence of calcitonin-secreting pancreatic tumors is underestimated.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
MRI, 18F-FDG PET/CT imaging, and immunostaining for calcitonin in Case 1. A, MRI scan shows a solid 18-mm lesion in the pancreatic tail (arrows), which appears hypointense on T1 and slightly hyperintense on T2. Contrast-enhanced sequences show hypervascularity in arterial phase with persistent enhancement in the subsequent phases. B, 18F-FDG PET/CT (in the upper part of the panel) and 18F-DOPA PET/TC (in the lower part of the panel) both show no significant metabolic activity in the pancreatic lesion. C, Immunostaining of the pancreatic nodule shows intense calcitonin staining (brown). MRI = magnetic resonance imaging.
FIGURE 2
FIGURE 2
Time course of postsurgical calcitonin normalization (solid: Case 1; open: Case 2).
See this image and copyright information in PMC

References

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