Carcinoma medular de tiroides metastásico a hígado y pulmón paciente asintomática con enfermedad activa
Medullary carcinoma of the thyroid with liver and lung metastases an assymptomatic patient with an active disease
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Cabal López, P. D. (2011). Carcinoma medular de tiroides metastásico a hígado y pulmón paciente asintomática con enfermedad activa. Revista Repertorio De Medicina Y Cirugía, 20(2), 124–127. https://doi.org/10.31260/RepertMedCir.v20.n2.2011.686
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El carcinoma medular de tiroides es un tumor poco frecuente y con baja prevalencia, derivado de las células C parafoliculares secretoras de calcitonina. De comportamiento agresivo suele invadir ganglios linfáticos, tejido glandular adyacente y hacer metástasis a hueso, pulmón e hígado. Presentamos una paciente de 26 años con dicho tumor metastático a pulmón e hígado. A pesar del manejo quirúrgico y médico concomitante persiste con actividad de la enfermedad y niveles elevados de calcitonina. Llama la atención la escasa sintomatología.
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Referencias
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2. Lundgren CI, Delbridg L, Learoyd D, Robinson B. Surgical approach to medullary thyroid cancer. Arq Bras Endocrino! Metabol. 2007;51(5):818-24.
3. Kebebew E, ltuarte P H, Siperstein AE, Duh QY, Clark OH. Medullary thyroid carcinoma:clinical characteristics, treatment, prognostic factors, and a comparison ofstaging systems. Cancer. 2000;88(5): 1139-48.
4. AI-Rawi M, Wheeler MH. Medullary tbyroid carcinoma update and present management controversies. Ann R Coll Surg Engl. 2006;88(5):433-8.
5. Bemier JJ, Rambaud JC, Cattan D, Prost A. Diarrhoea associated with medullary carcinoma ofthe thyroid. Gut. 1969;10(12):980-5.
6. Cohen MS, Phay JE, Albinson C et al. Gastrointestinal manifestations of multiple endocrine neoplasia type 2. Ann Surg. 2002;235(5):648-54.
7. Rambaud JC, Jian R, Flourie B et al. Pathophysiological study ofdiarrhoea in a patient with medullary thyroid carcinoma. Evidence against a secretory mechanism and for the role of shortened colonic transit time. Gut. 1988;29(4):537-43.
8. Sand M, Gelos M, Sand D et al. Serum calcitonin negative medullary thyroid carcinoma. World J Surg Oncol. 2006;4:97.
9. Barbet J, Campion L, Kraeber-Bodere F, Chata! JF. Prognostic impact of serum calcitonin andcarcinoembryonicantigen doubling-times in patients with medullary thyroid carcinoma. J Clin Endocrino! Metab. 2005;90(11):6077-84.
10. Chow SM, Chao JK, Tiu SC, Choi KL, Tang DL, Law SC. Medullary thyroid carcinoma in Hong Kong Chinese patients. Hong Kong Med J. 2005;11(4):251-8.
11. Machens A, Hauptmann S, Dralle H. Medullarythyroid cancer responsiveness to pentagastrin stimulation: an early surrogate parameter of tumor dissem:ination? JClin Endocrino] Metab. 2008;93(6):2234-8.
12. Brandao LG, Cavalheiro BG, Junqueira CR. Prognosticinfluence ofclinical and pathological factorsin medullary thyroid carcinoma: a study of53 cases. Clinics (Sao P aulo). 2009;64(9):849-56.
13. Fromigue J, De BT, Baudio E, Dromain C, Leboulleux S, Schlumberger M. Chemoembolization for liver metastases frommedullary thyroid carcinoma. J Clin Endocrino] Metab. 2006;91(7):2496-9.
14. Schott M, WillenbergHS, Sagert C et al. Identification ofoccult metastases of medullary thyroid carcinoma by pentagastrin-stimulated intravenous calcitonin sampling followed by targeted surgery. Clin Endocrino! (Oxf). 2007;66(3):405-9.
15. Esik O, Szavcsur P, Szakall S Jr et al. Angiography effectively supports the diagnosis ofhepatic metastases in medullary thyroid carcinoma. Cancer. 2001;91(11):2084-95.
16. Isozaki T, Kiba T, Numata K et al. Medullary thyroid carcinoma with multiple hepatic metastases: treatrnent with transcatheter arterial embolization and percutaneous ethanol injection. Intem Med. 1999;38(1):17-21.
17. Giraudet AL, Vanel D, Leboulleux S et al. Imaging medullary thyroid carcinoma with persisten! elevated calcitonin levels. JClin Endocrino! Metab. 2007;92(11):4185-90.
18. MachensA, Schneyer U, Holzhausen HJ, Dralle H. Prospects ofrem:ission in medullary thyroid carcinoma according to basal calcitonin leve!. J Clin Endocrino! Metab. 2005;90(4):2029-34.
19. Miccoli P, Minuto MN, Ugolini C et al. Clinically unpredictable prognostic factors in the outcome ofmedullary thyroid cancer. Endocr Relat Cancer. 2007;14(4):1099-1105.
2. Lundgren CI, Delbridg L, Learoyd D, Robinson B. Surgical approach to medullary thyroid cancer. Arq Bras Endocrino! Metabol. 2007;51(5):818-24.
3. Kebebew E, ltuarte P H, Siperstein AE, Duh QY, Clark OH. Medullary thyroid carcinoma:clinical characteristics, treatment, prognostic factors, and a comparison ofstaging systems. Cancer. 2000;88(5): 1139-48.
4. AI-Rawi M, Wheeler MH. Medullary tbyroid carcinoma update and present management controversies. Ann R Coll Surg Engl. 2006;88(5):433-8.
5. Bemier JJ, Rambaud JC, Cattan D, Prost A. Diarrhoea associated with medullary carcinoma ofthe thyroid. Gut. 1969;10(12):980-5.
6. Cohen MS, Phay JE, Albinson C et al. Gastrointestinal manifestations of multiple endocrine neoplasia type 2. Ann Surg. 2002;235(5):648-54.
7. Rambaud JC, Jian R, Flourie B et al. Pathophysiological study ofdiarrhoea in a patient with medullary thyroid carcinoma. Evidence against a secretory mechanism and for the role of shortened colonic transit time. Gut. 1988;29(4):537-43.
8. Sand M, Gelos M, Sand D et al. Serum calcitonin negative medullary thyroid carcinoma. World J Surg Oncol. 2006;4:97.
9. Barbet J, Campion L, Kraeber-Bodere F, Chata! JF. Prognostic impact of serum calcitonin andcarcinoembryonicantigen doubling-times in patients with medullary thyroid carcinoma. J Clin Endocrino! Metab. 2005;90(11):6077-84.
10. Chow SM, Chao JK, Tiu SC, Choi KL, Tang DL, Law SC. Medullary thyroid carcinoma in Hong Kong Chinese patients. Hong Kong Med J. 2005;11(4):251-8.
11. Machens A, Hauptmann S, Dralle H. Medullarythyroid cancer responsiveness to pentagastrin stimulation: an early surrogate parameter of tumor dissem:ination? JClin Endocrino] Metab. 2008;93(6):2234-8.
12. Brandao LG, Cavalheiro BG, Junqueira CR. Prognosticinfluence ofclinical and pathological factorsin medullary thyroid carcinoma: a study of53 cases. Clinics (Sao P aulo). 2009;64(9):849-56.
13. Fromigue J, De BT, Baudio E, Dromain C, Leboulleux S, Schlumberger M. Chemoembolization for liver metastases frommedullary thyroid carcinoma. J Clin Endocrino] Metab. 2006;91(7):2496-9.
14. Schott M, WillenbergHS, Sagert C et al. Identification ofoccult metastases of medullary thyroid carcinoma by pentagastrin-stimulated intravenous calcitonin sampling followed by targeted surgery. Clin Endocrino! (Oxf). 2007;66(3):405-9.
15. Esik O, Szavcsur P, Szakall S Jr et al. Angiography effectively supports the diagnosis ofhepatic metastases in medullary thyroid carcinoma. Cancer. 2001;91(11):2084-95.
16. Isozaki T, Kiba T, Numata K et al. Medullary thyroid carcinoma with multiple hepatic metastases: treatrnent with transcatheter arterial embolization and percutaneous ethanol injection. Intem Med. 1999;38(1):17-21.
17. Giraudet AL, Vanel D, Leboulleux S et al. Imaging medullary thyroid carcinoma with persisten! elevated calcitonin levels. JClin Endocrino! Metab. 2007;92(11):4185-90.
18. MachensA, Schneyer U, Holzhausen HJ, Dralle H. Prospects ofrem:ission in medullary thyroid carcinoma according to basal calcitonin leve!. J Clin Endocrino! Metab. 2005;90(4):2029-34.
19. Miccoli P, Minuto MN, Ugolini C et al. Clinically unpredictable prognostic factors in the outcome ofmedullary thyroid cancer. Endocr Relat Cancer. 2007;14(4):1099-1105.
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