José Paz-Ibarra, Jacsel Suárez-Rojas, Julio César Álvarez Gamero, Marcio Concepción-Zavaleta, Juan Eduardo Quiroz-Aldave, José Somocurcio-Peralta
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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.</p><p><strong>Conclusion: </strong>Serum calcitonin contributes to the diagnosis and monitoring of anterior intestine NETs.</p>","PeriodicalId":94316,"journal":{"name":"Endocrine, metabolic & immune disorders drug targets","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Calcitonin-producing Duodenal Neuroendocrine Tumor: A Case Report and Literature Review.\",\"authors\":\"José Paz-Ibarra, Jacsel Suárez-Rojas, Julio César Álvarez Gamero, Marcio Concepción-Zavaleta, Juan Eduardo Quiroz-Aldave, José Somocurcio-Peralta\",\"doi\":\"10.2174/0118715303309948240524054836\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>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.</p><p><strong>Case report: </strong>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. 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引用次数: 0
摘要
简介:神经内分泌肿瘤(NET神经内分泌肿瘤(NET)的临床表现多种多样,包括分泌各种激素。降钙素是甲状腺髓样癌[MTC]的敏感标志物,但它没有特异性,在甲状腺外NET中可能会升高:本病例是一名64岁的女性患者,因甲状腺峡部的一个结节而接受了甲状腺全切除术,细针穿刺活检显示其为滤泡性肿瘤。病理检查显示甲状腺大结节和小结节增生,并伴有甲状旁腺腺瘤。术后随访期间,发现降钙素进行性升高,达到64.2 pg/ml,而癌胚抗原水平保持正常。由于在复查甲状腺切除术标本时未发现 MTC 病灶,因此开始调查降钙素升高的原因。血清嗜铬粒蛋白 A 和特异性神经元烯醇化酶水平均在正常范围内。Tc-99m HYNIC-TOC闪烁扫描结果为阴性。此外,上消化道内镜检查发现十二指肠第二部分有粘膜下病变,活检证实为 1 级 NET。患者接受了Whipple手术和肝转移切除术。术后观察到血清降钙素水平基线有所下降。术后七年,她继续接受专门监测,未发现生化或影像学疾病证据:结论:血清降钙素原有助于诊断和监测前肠NET。
Calcitonin-producing Duodenal Neuroendocrine Tumor: A Case Report and Literature Review.
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 report: 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.