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Case Reports
. 2020 Jul 20;12(7):e9305.
doi: 10.7759/cureus.9305.

Small Cell Variant of Medullary Thyroid Carcinoma: A Possible Treatment

John Sherret  1 , Mohammad Alomari  1 , Joshua Coleman  1 , Agnes Hamati  2
Affiliations
Case Reports

Small Cell Variant of Medullary Thyroid Carcinoma: A Possible Treatment

John Sherret et al. Cureus. .

Abstract

Small cell variant of medullary thyroid carcinoma is an extremely rare histologic entity with a paucity of data. As such, there is a lack of literature and clinical experience regarding this disease. In this report, we examine a case of small cell variant of medullary thyroid carcinoma that presented with intractable nausea, vomiting and diarrhea. While these symptoms were essentially refractory to the standard symptomatic treatment, further laboratory analysis revealed dramatically elevated calcitonin levels and mildly raised thyroid-stimulating hormone levels. Interestingly, repletion of thyroid hormone and treatment with lanreotide resulted in an abatement of our patient's symptoms. This temporal clinical improvement highly suggests a potential role involving thyroid-stimulating hormone and calcitonin levels in the pathogenesis of this disease, and consequently suggests a role for thyroxine in treating the associated gastrointestinal symptoms.

Keywords: calcitonin; hypothyroidism; levothyroxine; medullary thyroid carcinoma; multiple endocrine neoplasia; nausea; octreotide; small cell variant; thyroid-stimulating hormone; vomiting.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. CT of the abdomen obtained two days prior to admission shows wall thickening and perisigmoid fat stranding.
Wall thickening is marked with an arrow head and the perisigmoid fat stranding is marked with an arrow.
Figure 2
Figure 2. CT of the abdomen obtained after alleviation of symptoms continues to show perisigmoid fat stranding and wall thickening.
Wall thickening is marked with an arrow head and the perisigmoid fat stranding is marked with an arrow.
See this image and copyright information in PMC

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