Endocrine Abstracts

A 65–year-old male was referred to endocrinologist due to significantly elevated calcitonin level of 3662 pg/ml. Previously, almost 3 decades before, the patient underwent right thyroid lobectomy for papillary carcinoma. Then, 9 years afterwards, he was reoperated and total thyroidectomy with neck exploration was performed. In pathohistological finding, metastatic papillary carcinoma was proved. Radioactive iodine ablation was used as a post surgical treatment. After completing a proposed therapeutic course, a patient has not been motivated for a regular follow-up. During the hospital examination, CT scan of the neck region revealed a solitary pathological node in front of the trachea, 18 mm in diameter which was surgically removed. Pathohistological finding was suggestive for metastatic medullary thyroid carcinoma. A bone scan and nuclear magnetic resonance demonstrated a 32 mm extramedullary intraspinal solid mass in Th10 region. In further course, a Galium PET/CT scan showed an increased update in right cervical level lymph node, measuring 12x8 mm in diameter, and in left side of the spinal canal at the level of Th9-Th10, consistent with metastasis, without pathological uptake on brain images, thorax, abdomen or pelvis. One month afterwards, a solid mass in spinal region and neck dissection were removed, followed with calcitonin level normalization.