title: [Diarrhea as the initial manifestation of medullary thyroid gland carcinoma].
abstract: BACKGROUND
  With the differential diagnosis of a diarrhea a lot of causes has to be considered. In very rare cases diarrhea can be the first symptom of a medullary thyroid carcinoma (MTC).
  
  
  METHODS
  A 28-year-old patient came to the admission department because of persisting diarrhea. A computerized tomography revealed multiple hepatic and pulmonary metastases. A medullary thyreoid carcinoma was found as the cause of it. The serum calcitonin values were highly increased, later the carcinoembryonal antigen (CEA), too. Sandostatin, a radioimmune therapy (131J-anti-CEA antibody) and adriamycin were therapeutically applied. The patient died 24 months after the occurrence of the first symptoms.
  
  
  CONCLUSIONS
  In case of persisting diarrhea the differential diagnosis of a medullary thyroid carcinoma must be taken into consideration and a calcitonin determination has to be arranged. Yet, typical symptoms like struma nodosa, swollen neck lymph nodes or a CEA increase can still be missing in the initial phase.
authors.affiliation: Klinik für Innere Medizin des Klinikums, Friedrich-Schiller-Universität Jena. hesselbarth@polkim.med.uni-jena.de
authors.forename: N
authors.initials: N
authors.lastname: Hesselbarth
authors.forename: T
authors.initials: T
authors.lastname: Eidner
authors.forename: J
authors.initials: J
authors.lastname: Hesse
authors.forename: E
authors.initials: E
authors.lastname: Schulze
authors.forename: H
authors.initials: H
authors.lastname: Bosseckert
mesh_terms: D000328:Adult; D018276:Carcinoma, Medullary / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000209:etiology*; D006801:Humans; D008297:Male; D013964:Thyroid Neoplasms / Q000175:diagnosis*