甲状腺外分泌降钙素肿瘤：多结节性甲状腺肿患者的胰腺神经内分泌肿瘤：两例报告
Extrathyroidal Calcitonin Secreting Tumors: Pancreatic Neuroendocrine Tumors in Patients With Multinodular Goiter: Two Case Reports.
作者信息
Giannetta Elisa, Gianfrilli Daniele, Pozza Carlotta, Lauretta Rosa, Graziadio Chiara, Sbardella Emilia, Baroli Alberto, Caronna Roberto, Chirletti Piero, Lenzi Andrea, Isidori Andrea M
机构信息
From the Department of Experimental Medicine, Sapienza University of Rome, Rome (EG, DG, CP, RL, CG, ES, AL, AMI); Nuclear Medicine Unit, Department of Interventional Oncology, Azienda Ospedaliera-Ospedale di Circolo di Busto Arsizio, Varese (AB); and Department of Surgical Science, Sapienza University of Rome, Rome, Italy (RC, PC).
出版信息
Medicine (Baltimore). 2016 Jan;95(3):e2419. doi: 10.1097/MD.0000000000002419.
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.
降钙素是甲状腺髓样癌的标志。然而，甲状腺外神经内分泌肿瘤也可释放降钙素。我们报告了2例在11个月内转诊至我们中心的无症状甲状腺结节患者中发现的分泌降钙素的胰腺肿瘤病例。病例1：一名最初因甲状腺结节特征评估前来就诊的男性，在非肿瘤性细针穿刺过程中发现有高降钙素血症（>200 pg/mL）。病例2：一名因肝转移接受评估的女性，发现有高降钙素血症和多结节性甲状腺肿。我们的研究强调，存在甲状腺结节时出现明显的高降钙素血症不一定是由甲状腺髓样癌引起的；认识到这一点可以避免不必要的甲状腺切除术。与高降钙素血症相关的特异性症状缺乏可能是分泌降钙素的胰腺肿瘤患病率被低估的原因。
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