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A Calcitonin-Negative Neuroendocrine Tumor Derived from Follicular Lesions of the Thyroid.

Kim GY, Park CY, Cho CH, Park JS, Jung ED, Jeon EJ - Endocrinol Metab (Seoul) (2014)

Bottom Line: Initially, USG-guided aspiration cytology was performed, and a MTC was suspected.The expressions of thyroglobulin and thyroid transcription factor-1, which are thyroid follicular cell markers, and synaptophysin and chromogranin A, which are neuroendocrine markers, was confirmed following surgical pathology.However, the staining of calcitonin, a marker of MTCs, was not observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.

ABSTRACT
Neuroendocrine lesions of the thyroid are rare. The most common types are medullary thyroid carcinomas (MTCs) and C-cell hyperplasia. MTCs originate from thyroid parafollicular cells that secrete calcitonin which serves as a serum marker of MTCs. Here, the rare case of a calcitonin-negative neuroendocrine tumor (NET) derived from follicular lesions of the thyroid is described. A 34-year-old man presented at our hospital for the surgical management of an incidental thyroid nodule that was observed on an ultrasound sonography (USG) of the neck. Initially, USG-guided aspiration cytology was performed, and a MTC was suspected. The expressions of thyroglobulin and thyroid transcription factor-1, which are thyroid follicular cell markers, and synaptophysin and chromogranin A, which are neuroendocrine markers, was confirmed following surgical pathology. However, the staining of calcitonin, a marker of MTCs, was not observed. A nonmedullary NET of the thyroid is uncommon, and the distinction between calcitonin-negative NETs and MTCs of the thyroid may be important due to differences in their clinical courses and management.

No MeSH data available.


Related in: MedlinePlus

Thyroid ultrasound sonography showing an approximately 0.88×0.57×0.88 cm-sized hypoechoic nodule (A, yellow arrow) with increased vascularity (B) of the right lobe.
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Figure 1: Thyroid ultrasound sonography showing an approximately 0.88×0.57×0.88 cm-sized hypoechoic nodule (A, yellow arrow) with increased vascularity (B) of the right lobe.

Mentions: The patient did not exhibit any symptoms and did not have a personal or family history of endocrine disorders or a previous history of exposure to radiation. An examination of the neck did not reveal a palpable nodule or lymphadenopathy, and his physical examination was unremarkable. Prior to the operation, the patient's serum levels of calcium, thyroid stimulating hormone, and free thyroxine were within normal ranges. His serum levels of thyroglobulin antigen were 11.64 ng/mL (normal range, 1.4 to 78.0), his thyroid microsomal antibody was negative, and his serum calcitonin level was 3.70 pg/mL (normal range, <10). The patient's carcinoembryonic antigen (CEA) levels were not measured preoperatively, but a solitary hypoechoic nodule of approximately 0.88×0.57×0.88 cm with increased blood flow was observed in the right thyroid following a USG (Fig. 1). A cervical contrast-enhanced computed tomography (CT) scan revealed a low density nodule in the same area. A chest roentgenogram, an electrocardiogram, and positron emission tomography/CT scans did not reveal any abnormalities, and there was no evidence of metastasis to the lymph nodes or other organs. The tentative diagnosis was a NET of the thyroid.


A Calcitonin-Negative Neuroendocrine Tumor Derived from Follicular Lesions of the Thyroid.

Kim GY, Park CY, Cho CH, Park JS, Jung ED, Jeon EJ - Endocrinol Metab (Seoul) (2014)

Thyroid ultrasound sonography showing an approximately 0.88×0.57×0.88 cm-sized hypoechoic nodule (A, yellow arrow) with increased vascularity (B) of the right lobe.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508268&req=5

Figure 1: Thyroid ultrasound sonography showing an approximately 0.88×0.57×0.88 cm-sized hypoechoic nodule (A, yellow arrow) with increased vascularity (B) of the right lobe.
Mentions: The patient did not exhibit any symptoms and did not have a personal or family history of endocrine disorders or a previous history of exposure to radiation. An examination of the neck did not reveal a palpable nodule or lymphadenopathy, and his physical examination was unremarkable. Prior to the operation, the patient's serum levels of calcium, thyroid stimulating hormone, and free thyroxine were within normal ranges. His serum levels of thyroglobulin antigen were 11.64 ng/mL (normal range, 1.4 to 78.0), his thyroid microsomal antibody was negative, and his serum calcitonin level was 3.70 pg/mL (normal range, <10). The patient's carcinoembryonic antigen (CEA) levels were not measured preoperatively, but a solitary hypoechoic nodule of approximately 0.88×0.57×0.88 cm with increased blood flow was observed in the right thyroid following a USG (Fig. 1). A cervical contrast-enhanced computed tomography (CT) scan revealed a low density nodule in the same area. A chest roentgenogram, an electrocardiogram, and positron emission tomography/CT scans did not reveal any abnormalities, and there was no evidence of metastasis to the lymph nodes or other organs. The tentative diagnosis was a NET of the thyroid.

Bottom Line: Initially, USG-guided aspiration cytology was performed, and a MTC was suspected.The expressions of thyroglobulin and thyroid transcription factor-1, which are thyroid follicular cell markers, and synaptophysin and chromogranin A, which are neuroendocrine markers, was confirmed following surgical pathology.However, the staining of calcitonin, a marker of MTCs, was not observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.

ABSTRACT
Neuroendocrine lesions of the thyroid are rare. The most common types are medullary thyroid carcinomas (MTCs) and C-cell hyperplasia. MTCs originate from thyroid parafollicular cells that secrete calcitonin which serves as a serum marker of MTCs. Here, the rare case of a calcitonin-negative neuroendocrine tumor (NET) derived from follicular lesions of the thyroid is described. A 34-year-old man presented at our hospital for the surgical management of an incidental thyroid nodule that was observed on an ultrasound sonography (USG) of the neck. Initially, USG-guided aspiration cytology was performed, and a MTC was suspected. The expressions of thyroglobulin and thyroid transcription factor-1, which are thyroid follicular cell markers, and synaptophysin and chromogranin A, which are neuroendocrine markers, was confirmed following surgical pathology. However, the staining of calcitonin, a marker of MTCs, was not observed. A nonmedullary NET of the thyroid is uncommon, and the distinction between calcitonin-negative NETs and MTCs of the thyroid may be important due to differences in their clinical courses and management.

No MeSH data available.


Related in: MedlinePlus