Medullary thyroid microcarcinoma revealed by lymph node metastases. about a case

Karimi Meryem; Hajar Azagouagh; Nawal Moussaid; Rifai Kaoutar; Iraqi Hind; Gharbi Mohamed Elhassan

doi:10.1530/endoabs.99.EP1081

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Endocrine Abstracts (2024) 99 EP1081 | DOI: 10.1530/endoabs.99.EP1081

ECE2024 Eposter Presentations Pituitary and Neuroendocrinology (214 abstracts)

Medullary thyroid microcarcinoma revealed by lymph node metastases. about a case

Karimi Meryem ¹ , Hajar Azagouagh ¹ , Nawal Moussaid ¹ , Rifai Kaoutar ¹ , Iraqi Hind ¹ & Mohamed Elhassan Gharbi ¹

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¹Chu Ibn Sina, Endocrinology Rabat, Morocco

Introduction: Micro medullar, thyroid carcinoma is defined as a rare variant of MTC, with a size less than or equal to 1 cm, often incidentall, discovered.

Observation: A 67-year-old patient with no medical history presented with two supraclavicular lymph nodes four years ago. A biopsy revealed metastatic tumor proliferation suggestive of a carcinomatous process. Immunohistochemistry confirmed cervical lymph node metastasis of MTC, and further testing showed a calcitonin level of 10,769 ng/ml. A PET SCAN revealed no anomalies, and a thorough evaluation for multiple endocrine neoplasia (MEN) was normal. Total thyroidectomy with bilateral extensive lymph node dissection was performed, revealing a 5mm intraparenchymal low-grade micro medullary carcinoma.

Discussionl and Conclusion: Contrary to the common perception of micro medullary thyroid carcinoma as having a favorable prognosis, a significant increase in the prevalence of lymph node metastases is observed. Due to the severity of complications associated with recurrences and distant metastases, two approaches are utilized: regular monitoring of serum calcitonin levels, showing a decreasing trend, and genetic screening, particularly in hereditary cases. Biochemical screening programs are crucial for identifying sporadic cases of micro medullary thyroid carcinoma in patients with thyroid nodules.