Diarrhea as a form of presentation of medullary thyroid carcinoma

Pais, Mariana Canelas; Maia, Tiago; Peixoto, Armando; Meira, Leonor; Albuquerque, Andreia; Lopes, Joanne; Capela, João

doi:10.1016/j.pbj.0000000000000018

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…Diarrhea is a rare symptom of MTC which, when present, could be due to increased secretion of calcitonin and other active peptides by tumor cells. 21 Our patient presented with diarrhea as the primary chief complaint prompting extensive workup, which was negative. Healthcare providers must have malignancies like MTC at the back of their minds while evaluating patients with chronic diarrhea.…”

Section: Discussionmentioning

confidence: 76%

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An unusual cause of chronic diarrhea in a Middle‐Aged adult: A diagnostic challenge

Reddy

Nwankwo

Sekar

et al. 2023

Clinical Case Reports

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Section: Discussionmentioning

confidence: 76%

“…Medullary thyroid cancer can present with various symptoms. Diarrhea is a rare symptom of MTC which, when present, could be due to increased secretion of calcitonin and other active peptides by tumor cells 21 . Our patient presented with diarrhea as the primary chief complaint prompting extensive workup, which was negative.…”

Section: Discussionmentioning

confidence: 79%

An unusual cause of chronic diarrhea in a Middle‐Aged adult: A diagnostic challenge

Reddy

Nwankwo

Sekar

et al. 2023

Clinical Case Reports

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“…DTC and MTC generally grow slowly, and patients with metastatic disease may live without any symptoms for long periods. Therefore, the use of TKIs should be limited to the patients with progressive disease or with tumor-related symptoms such as diarrhea caused by MTC [59]. The doubling time of serum markers, thyroglobulin for DTC and calcitonin for MTC, has been investigated to predict disease progression [60,61].…”

Section: Discussionmentioning

confidence: 99%

Comparative efficacy and safety of tyrosine kinase inhibitors for thyroid cancer: a systematic review and meta-analysis

et al. 2020

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The tyrosine kinase inhibitors (TKIs) sorafenib, lenvatinib, vandetanib, and cabozantinib are currently used for thyroid cancer treatment; however, the differences in their clinical efficacy and toxicity remain unclear. This meta-analysis assessed the efficacy and toxicity of these four TKIs based on 34 studies. The pooled incidence of partial response (PR), stable disease (SD), TKI-related adverse events (AEs), and pooled median progression-free survival (PFS) were calculated with 95% confidence intervals (CI). Complete response to TKIs was extremely rare (0.3%). The highest PR rate and longest PFS were observed for lenvatinib in differentiated thyroid cancer (69%, 95% CI: 57-81 and 19 months, 95% CI: 9-29, respectively) and vandetanib in medullary thyroid cancer (40%, 95% CI: 25-56 and 31 months, 95% CI: 19-43, respectively). Although the discontinuation rate due to AEs was similar for each TKI, there was a difference in the most frequently observed AE for each TKI (hand-foot syndrome for sorafenib, hypertension and proteinuria for lenvatinib, and QTc prolongation for vandetanib). The identified differences in the TKI efficacy and AE profiles may provide a better understanding of thyroid cancer treatment. Although TKIs are promising agents for thyroid cancer treatment, they are unlikely to lead to a cure. Thus, even in the TKI era, a multimodal treatment including surgery, radioiodine therapy, external beam radiotherapy, and TKIs is required to optimize patient chances of improved survival.

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