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Endocrine, Metabolic & Immune Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

Case Report

Calcitonin-producing Duodenal Neuroendocrine Tumor: A Case Report and Literature Review

In Press, (this is not the final "Version of Record"). Available online 24 June, 2024
Author(s): José Paz-Ibarra, Jacsel Suárez-Rojas, Julio César Álvarez Gamero, Marcio Concepción-Zavaleta*, Juan Eduardo Quiroz-Aldave and José Somocurcio-Peralta
Published on: 24 June, 2024

DOI: 10.2174/0118715303309948240524054836

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Abstract

Introduction: Neuroendocrine tumors [NETs] exhibit a wide range of clinical presentations, including the production of various hormones. Calcitonin, a sensitive marker for medullary thyroid cancer [MTC], is nonspecific and may be elevated in extra-thyroidal NETs.

Case Report: We present the case of a 64-year-old female patient who underwent total thyroidectomy due to a nodule in the isthmus, with a fine-needle aspiration biopsy indicating follicular neoplasia. Pathological examination revealed macro- and micro-nodular thyroid hyperplasia, along with a parathyroid adenoma. During postoperative follow-up, a progressive elevation of calcitonin was observed, reaching 64.2 pg/ml, while carcinoembryonic antigen levels remained normal. Since no MTC foci were found upon reviewing the thyroidectomy specimen, an investigation into the origin of the elevated calcitonin was initiated. Serum chromogranin A and specific neuronal enolase levels were within normal ranges. Tc-99m HYNIC-TOC scintigraphy yielded negative results. Additionally, an upper gastrointestinal endoscopy revealed a submucosal lesion in the second portion of the duodenum, with a biopsy confirming a grade 1 NET. The patient underwent Whipple surgery and hepatic metastasectomy. Postoperatively, a decrease in baseline serum calcitonin levels was observed. Seven years after surgery, she continues specialized monitoring with no biochemical or imaging evidence of disease.

Conclusion: Serum calcitonin contributes to the diagnosis and monitoring of anterior intestine NETs.

Keywords: Calcitonin, neuroendocrine tumors, chromogranin A, intestinal neoplasms, medullary carcinoma, HYNIC-TOC


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