ECE2021 Audio Eposter Presentations Thyroid (157 abstracts)
Persistently elevated procalcitonin levels in Covid-19 pneumoniae leading to medullary thyroid cancer diagnosis
Laura Gianotti 1 , Salvatore D’Agnano 2 , Francesco Tassone 1 , Giorgio Pettiti 3 , Giuseppe Lauria 4 , Valerio Del Bono 5 & Giorgio Borretta 1
1Azienda Ospedaliera S. Croce e Carle Cuneo, Division of Endocrinology, Diabetology & Metabolism, Cuneo, Italy; 2Azienda Ospedaliera S. Croce e Carle Cuneo, Division of Internal Medicine, Cuneo, Italy; 3Azienda Ospedaliera S. Croce e Carle Cuneo, Division of Rheumatology, Cuneo, Italy; 4Azienda Ospedaliera S. Croce e Carle Cuneo, Division of Emergency Medicine, Cuneo, Italy; 5Azienda Ospedaliera S. Croce e Carle Cuneo, Division of Infectious Diseases, Cuneo, Italy
Objective
We report a case of acute respiratory syndrome coronavirus 2 (SARSCoV2) pneumonia in which persistently high procalcitonin (PCT) allowed the diagnosis of sporadic medullary thyroid cancer (MTC).
Methods
We describe the history of 43-year-old male with bilateral Sars-Cov-2 pneumoniae, in whom persistent increased PCT despite reduction of C reactive protein lead to investigate other causes of high PCT. Serum calcitonin (CTN) was measured and a painless, right latero-cervical swelling as well as thyroid nodules were found.
Results
Serum PCT and CTN were 94 ng/ml and over 2000 pg/ml, respectively. A thyroid ultrasound and cytological examination by fine needle aspiration confirmed the diagnosis of MTC. The patient underwent total thyroidectomy with bilateral cervical lymph nodes dissection. Histological analysis confirmed MTC of right thyroid lobe and metastasis at lymph nodes of the central right midneck area.
Conclusions
Although CTN represents the gold standard biochemical parameter for the diagnosis and follow-up of MTC, it can be affected by physiologic and pathologic conditions. PCT has recently been regarded as potential marker of MTC achieving high sensitivity and specificity. In the present case, high levels of PCT in the absence of signs of bacterial infection, allowed to diagnose MCT. Hence, in the absence of any other sign of infection, a complete clinical assessment, including neck palpation, calcitonin measurement and thyroid ultrasound should be performed in the presence of persistent elevated PCT. PCT could be a new diagnostic tool or a supplementary biomarker in the management of MTC.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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