Giessen Hanna, Nebiker Christian A, Bruehlmeier Matthias, Spreitzer Stefan, Mueller Beat, Schuetz Philipp
Department of Internal Medicine, Kantonsspital Aarau, Aarau 5000, Switzerland.
Department of Surgery, Kantonsspital Aarau, Aarau 5000, Switzerland.
World J Clin Cases. 2017 Dec 16;5(12):437-439. doi: 10.12998/wjcc.v5.i12.437.
A healthy woman volunteered to participate as "healthy control" in a study. An increased level of procalcitonin (PCT) was detected and remained elevated on follow-up measurements. As calcitonin levels were elevated as well, thyroid ultrasound was performed which revealed nodes in both thyroid lobes, one of them showing metabolic activity in positron emission tomography-computed tomography scan. To exclude a malignant thyroid cancer despite the negative findings in a fine needle aspiration the patient underwent thyroidectomy and a medullary thyroid carcinoma (MTC) was detected in the right lobe. MTC is a rare endocrine tumor with a poor prognosis once having spread, therefore early detection remains a priority for the outcome. Screening parameter is serum calcitonin, in absence of infection the pro-hormone PCT can be used as a screening parameter as well with high sensitivity.
一名健康女性自愿作为“健康对照”参与一项研究。检测到降钙素原(PCT)水平升高,且在后续测量中一直居高不下。由于降钙素水平也升高,于是进行了甲状腺超声检查,结果显示双侧甲状腺叶均有结节,其中一个在正电子发射断层扫描-计算机断层扫描中显示有代谢活性。尽管细针穿刺结果为阴性,但为排除甲状腺恶性肿瘤,该患者接受了甲状腺切除术,结果在右叶发现了甲状腺髓样癌(MTC)。MTC是一种罕见的内分泌肿瘤,一旦扩散,预后较差,因此早期检测仍然是影响预后的关键。筛查指标是血清降钙素,在没有感染的情况下,前体激素PCT也可作为筛查指标,且灵敏度较高。