Hypercalcitoninemia, Nodular Goiter, and Pancreatic Tumor
Abstract
Hypercalcitoninemia, J.P. GHNASSIA,1 V. Nodular Goiter, and Pancreatic Tumor LINDNER,2 O. SCHNEEGANS,1 and P. HAEGELÃ1 INTRODUCTION However, other thyroid medullary causes of hypercacitoninemia have to be ruled out before to retain such a diagnosis as illustrated by this case study. CASE STUDY A 52-year-old woman was admitted to the hospital with persistent chest pain and a cough. There was no medical history except for a multinodular goiter that had been pres¬ high calcitonin In of plasma concentration is generally considered pathognomonic carcinoma. the context of a thyroid tumor, a as An autopsy was performed and revealed a multinodular goiter and a caudal pancreatic tumor of 3 cm in diameter with mediastinal lymph node, lung, hepatic, and osseous métastases. On microscopic examination, the pancreatic tumor was a poorly differentiated neuroendocrine carci¬ noma. An immunohistochemical study with an anticalcitonin antibody demonstrated intense labelling in most of the neoplastic cells (Fig. 1). Furthermore, some cells were labelled by an antisomatostatin antibody and an antivasoactive intestinal peptide antibody. Neoplastic cells failed to stain with any of the other peptide antibodies used (in¬ for a long time. Chest x-rays showed a right lung up¬ per lobe nodular mass. Computed tomography scan and ent