Advanced medullary thyroid carcinoma uncovered by persistently elevated procalcitonin in a patient with COVID-19.

Autor:	Bucci I; Department of Medicine and Aging Sciences, Center for Advanced Studies and Technology (CAST), G.d'Annunzio University Chieti-Pescara, Chieti, Italy.; Endocrinology and Metabolism Unit, ASL Pescara, Pescara, Italy., Di Dalmazi G; Endocrinology and Metabolism Unit, ASL Pescara, Pescara, Italy., Giuliani C; Department of Medicine and Aging Sciences, Center for Advanced Studies and Technology (CAST), G.d'Annunzio University Chieti-Pescara, Chieti, Italy., Russo P; Endocrinology and Metabolism Unit, ASL Pescara, Pescara, Italy., Ciappini B; Endocrinology and Metabolism Unit, ASL Pescara, Pescara, Italy., Amatetti C; Medical Oncology, Santo Spirito Hospital, Pescara, Italy., Guarino P; Otorhinolaryngology Head and Neck Surgery Unit, Santo Spirito Hospital, Pescara, Italy., Napolitano G; Department of Medicine and Aging Sciences, Center for Advanced Studies and Technology (CAST), G.d'Annunzio University Chieti-Pescara, Chieti, Italy.; Endocrinology and Metabolism Unit, ASL Pescara, Pescara, Italy.
Jazyk:	angličtina
Zdroj:	Endocrinology, diabetes & metabolism case reports [Endocrinol Diabetes Metab Case Rep] 2024 Jul 25; Vol. 2024 (3). Date of Electronic Publication: 2024 Jul 25 (Print Publication: 2024).
DOI:	10.1530/EDM-24-0052
Abstrakt:	Summary: We report the case of an 88-year-old man hospitalized for COVID-19 with persistently very high procalcitonin (proCt) levels despite infection resolution. Since proCt is an adjunct tumor marker in the diagnosis of medullary thyroid carcinoma (MTC), serum calcitonin (Ct) was also measured showing very high levels. Computed tomography (CT) scan showed the presence of a thyroid mass and neck ultrasound revealed a solid isoechoic, inhomogeneous, 50 mm nodule in the right thyroid lobe, extended into the mediastinum. Fine needle aspiration (FNA) of the thyroid nodule confirmed the diagnosis of MTC. An 18F-fluorodopa positron emission tomography/computed tomography (PET/CT) scan revealed the presence of distant metastases in ribs, vertebrae, in the right iliac wing and the liver. Since surgery was not feasible, the patient was started on cabozantinib 40 mg/dL. After 16 months the patient is still on cabozantinib at the same dose, he reports complete autonomy in daily life activities, and serum Ct is still elevated; however, the imaging evaluation does not show signs of disease progression. Learning Points: High procalcitonin serum values despite the absence of infection are suggestive of MTC. Advanced MTC with multiple metastases can have an indolent course and can go unrecognized for years. Cabozantinib is a valuable option for the treatment of advanced MTC.
Databáze:	MEDLINE
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