Primary high-grade calcitonin-negative neuroendocrine carcinoma of the thyroid: a very rare cancer
| Autor: | José Cameselle-Teijeiro, Joseph A. Chorny, John J. Orrego |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Pathology
medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Calcitonin gene-related peptide Neuroendocrine tumors lcsh:Diseases of the endocrine glands. Clinical endocrinology Thyroid carcinoma 03 medical and health sciences 0302 clinical medicine Carcinoembryonic antigen Internal Medicine medicine lcsh:RC648-665 biology business.industry Thyroid Medullary thyroid cancer medicine.disease medicine.anatomical_structure Calcitonin 030220 oncology & carcinogenesis biology.protein Thyroglobulin business New Disease or Syndrome: Presentations/Diagnosis/Management |
| Zdroj: | Endocrinology, Diabetes & Metabolism Case Reports Endocrinology, Diabetes & Metabolism Case Reports, Vol 1, Iss 1, Pp 1-4 (2018) |
| ISSN: | 2052-0573 |
| Popis: | Summary Most medullary thyroid carcinomas (MTCs) are low grade and produce calcitonin. There are some calcitonin-negative MTCs that produce only calcitonin gene-related peptide (CGRP). Rarely, MTCs are negative for calcitonin and CGRP peptides, but contain their corresponding mRNAs. Primary thyroid neuroendocrine neoplasms other than MTCs are extremely rare. We describe a primary high-grade neuroendocrine carcinoma that was negative for CGRP and calcitonin at both the protein and mRNA levels. A 42-year-old woman presented with a rapidly enlarging thyroid mass replacing most of the left lobe and isthmus. A computed tomography-guided core-needle biopsy was performed. The tumor was composed of sheets of small-to-medium sized epithelial cells. The cells were immunoreactive for pancytokeratin, synaptophysin, CD56 and thyroid transcription factor-1, but negative for CK7, CK20, CD45, CD99, ERG, chromogranin A, thyroglobulin, calcitonin, CGRP and carcinoembryonic antigen. The Ki-67 proliferation index was ~90%. In situ hybridization was negative for calcitonin mRNA. The patient was initially diagnosed as having a small cell carcinoma. She was treated with cisplatin and etoposide (VP16), followed by radiation therapy. Given the excellent clinical course, the tumor was reviewed and reclassified as a high-grade neuroendocrine carcinoma (non-small-cell type). Heretofore, only a few other similar high-grade neuroendocrine tumors with negative markers of C-cell derivation have been reported. In our case, the patient is cancer free five years after diagnosis, but in the other cases, the outcome was poor. Learning points: There are neuroendocrine carcinomas of the thyroid that do not produce calcitonin or calcitonin gene-related peptide. This category of calcitonin-negative neuroendocrine carcinomas is heterogeneous, consisting of low- and high-grade tumors. The high-grade neuroendocrine carcinomas of the thyroid are rare and generally have a poor prognosis. They are divided into small cell and non-small cell or large cell types. |
| Databáze: | OpenAIRE |
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