Endocrine Abstracts

Medullary carcinoma of the thyroid (MCT) is a tumor developed at the expense of the thyroid parafollicular cells, and secretes the polypeptide hormone calcitonin. It is known as an aggressive tumor that metastasizes early. Case Report: We describe a case of a 57 year-old women, who presented a neck mass, for which she underwent a total thyroidectomy associated to a bilateral neck dissection and was diagnose as MCT. Post operatively calcitonin remained elevated (19000 pg/ml). Computed tomography reveled multiples calcified masses in the liver, consisting in hepatic metastases. In the other hand bone scintigraphy with technitium-99m demonstrated not only multiples metastatic lesions in lumber spine but also extensive areas of uptake of Tc99 m in the liver. Liver uptake of technetium-99m MDP in hepatic MTC metastasis has rarely been reported in previous publications. Possible mechanisms of uptake might include adsorption of amorphous calcium due to the fact that these tumors do calcify. Other possibilities include calcitonin– calcium metabolism, active sequestration, or secretion of one of the tumor hormones.