Medullary carcinoma of the thyroid with serotonin production and carcinoid-like syndrome

Hočevar, Marko; Bergant, Damijan; Auersperg, M.; Golouh, Rastko

doi:10.1053/ejso.2000.1032

Cited by 5 publications

(3 citation statements)

References 19 publications

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“…Abbreviations: CEA, carcino-embryonic antigen; DOPAC, dihydroxyphenylacetic acid; HVA, homovanillic acid; 3-MT, 3-methoxytyramine; VMA, vanillylmandelic acid; VA, vanillic acid; MOPEG, 3-methoxy-4-hydroxyphenylethyleneglycol; 5-HIAA, 5-hydroxyindole acetic acid; MIMAA, methylimidazole acetic acid In addition to catecholamine-excreting capacities of MTC, we found increased plasma platelet serotonin levels in approximately 15% of MTCs and only in patients with MEN 2. Conflicting findings mentioned either increased (20)(21)(22) or undetectable (9) amounts of serotonin in serum and tissue of several patients with MTC and comparable serum serotonin or urine 5-HIAA levels in patients with MTC and healthy controls (23,24). The high number of patients with elevated serotonin levels found in this study could be explained by the use of platelet serotonin which is more sensitive to measure serotonin synthesis than urine 5-HIAA or serum serotonin (13,25).…”

Section: Discussioncontrasting

confidence: 68%

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Biochemical Markers in the Follow-up of Medullary Thyroid Cancer

Groot

Kema

Breukelman

et al. 2006

Thyroid

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Medullary thyroid cancer (MTC) shares biochemical features with other neuroendocrine tumors but the particular characteristics are largely unexplored. We investigated the biochemical neuroendocrine profile of MTC and whether specific markers could be useful in follow-up. In addition to the standard tumor marker calcitonin, plasma carcino-embryonic antigen (CEA), plasma catecholamines, (platelet) serotonin, chromogranin A, tryptase, and urinary markers of catecholamine, histamine, and serotonin metabolism were prospectively determined in 46 patients with histologically proven MTC. Patients were divided according to the stage of disease: group 1, no evidence; group 2, stable disease (SD); and group 3, progressive disease (PD). Plasma dopamine was increased in the majority of the patients with SD and PD; however it did not correlate with extent of disease. Elevated plasma platelet levels of serotonin were only present in patients with multiple endocrine neoplasia 2 with SD or PD but did not differ between those groups. Histamine metabolites were elevated in 20% of patients with SD and PD. In addition to plasma calcitonin, only CEA and chromogranin A could differentiate between stable and progressive MTC. MTCs are capable of synthesizing catecholamines, serotonin, and histamine metabolites underscoring that MTCs have metabolic characteristics in common with other neuroendocrine tumors. Thus far, clinical usefulness and relevance seems limited. The most useful markers in the follow-up of MTC are plasma calcitonin and CEA.

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Section: Discussioncontrasting

confidence: 68%

“…Furthermore, secretion of serotonin and histamine may account for some of the symptoms of the carcinoid syndrome (29,30). It is possible that release of these compounds from MTCs can cause side effects, such as arrhythmia and perioperative carcinoid crisis in a subset of patients (22,31,32).…”

Section: Discussionmentioning

confidence: 99%

Biochemical Markers in the Follow-up of Medullary Thyroid Cancer

Groot

Kema

Breukelman

et al. 2006

Thyroid

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“…Also, the thyroid C cells carry out synthesis and/or uptake of amines. The presence of 5-hydroxytryptamine (serotonin) in patients with MTC has rarely been described [8, 10]. Although symptoms related to serotonin secretion such as cervicothoracicflushing, secretory diarrhea and heart failure [11] were not present in this case, the 5-hydroxyindoleacetic acid assay was performed to rule out the presence of carcinoid tumor as the cause of CS presented by the patient.…”

Section: Discussionmentioning

confidence: 97%

Atypical Presentation of a Medullary Thyroid Carcinoma Producing Acth and Serotonin

et al. 2019

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Medullary carcinoma accounts for about 5% of all thyroid malignancies. The tumor may produce other hormones in addition to calcitonin that typically occurs in the presence of distant metastases. The aim of this report is to present a case of invasive medullary thyroid carcinoma producing ACTH and serotonin. A male patient sought medical attention due to facial plethora and distal paresthesia. On thyroid ultrasound, he presented a hypoechoic nodule measuring 6.7 × 3.2 × 3.5 cm, with punctate calcifications and central vascular pattern. The chest computed tomography showed an extensive solid lesion with epicenter in the superior mediastinum and absence of a cleavage plane with the left thyroid lobe. The lesion extended from the glottic area to the lower portion of the trachea and invaded esophagus, posterior tracheal wall, and left jugular. The patient presented hyperglycemia, hypokalemia, increased free urinary cortisol, calcitonin, ACTH and 5-hydroxyindoleacetic acid levels. The nodule cytological examination obtained by fine-needle aspiration was inconclusive, and the open biopsy confirmed the diagnosis of medullary thyroid carcinoma. Due to the advanced disease stage and increased risk of large caliber vessels injury in case of surgery, local chemotherapy and radiotherapy were recommended. With this report, we want to draw attention to an unusual association between advanced medullary thyroid carcinoma with an aggressive course and ectopic production of ACTH and serotonin.

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Paraneoplastic syndromes in patients with laryngeal neuroendocrine carcinomas: clinical manifestations and prognostic significance

Ferlito

Rinaldo

Bishop

et al. 2014

Eur Arch Otorhinolaryngol

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Paraneoplastic syndromes are associated with a variety of malignant neoplasms and are systemic and non-metastatic manifestations that develop in a minority of cancer patients. This review examines all published cases of paraneoplastic syndromes associated with neuroendocrine carcinomas of the larynx. There are a total of ten patients reported with paraneoplastic syndromes associated with laryngeal neuroendocrine carcinomas in the literature. Of these, nine died and the tenth is alive with liver metastases. There were five cases of small-cell neuroendocrine carcinoma, four cases of moderately differentiated neuroendocrine carcinoma, and one case of well-differentiated neuroendocrine carcinoma associated with paraneoplastic syndromes. As these syndromes have significant clinical relevance, physicians should be aware of the possible presence of paraneoplastic syndromes in the diagnostic process of patients with neuroendocrine carcinoma of the larynx.

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Medullary carcinoma of the thyroid with serotonin production and carcinoid-like syndrome

Cited by 5 publications

References 19 publications

Biochemical Markers in the Follow-up of Medullary Thyroid Cancer

Biochemical Markers in the Follow-up of Medullary Thyroid Cancer

Atypical Presentation of a Medullary Thyroid Carcinoma Producing Acth and Serotonin

Paraneoplastic syndromes in patients with laryngeal neuroendocrine carcinomas: clinical manifestations and prognostic significance

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