Abstract
The article is concerned with medullary microcarcinoma of the thyroid. Similarly to medullary macrocarcinoma, this may metastasize to distant sites.
Reported is a case of a 54-year-old male who had suffered from chest tightness and dry irritating cough. Chest X-ray showed small nodules with poorly-defined borders of unknown etiology.
Lung bio-psy was performed, which detected amyloid-rich neuroendocrine carcinoma. Examination of the thyroid was recommended to confirm or rule out suspected medullary carcinoma.
The bio-psy examination also suggested G1 and G2 primary neuroendocrine carcinoma of the lung or diffuse idiopathic pulmonary neuroendocrine cell hyperplasia. Numerous examinations using imaging methods (CT, MRI, PET-CT) were carried out with no positive results in the thyroid.
Despite that, thyroidectomy was performed. Subsequent bio-psy examination revealed medullary microcarcinoma sized 0.6 cm.
Apart from lung metastases, tumor lesions were found in cervical lymph nodes. This case is an example of a close cooperation between a pathologist and a clinician - endocrinologist.
Based on serum calcitonin levels, this may aid in differential diagnosis.