title: [Medullary thyroid cancer, a tumour with many appearances].
abstract: Medullary thyroid cancer (MTC) has a variable clinical presentation. We present 3 patients with this endocrine tumour. The first patient, a 41-year-old woman complaining of diarrhoea, a painful abdomen, weight loss and sensibility disorders in both legs, had metastases of MTC in the spine, with little progression during 2 years of follow-up. The second patient, a 64-year-old woman suffering from a painful nodule in the neck and a painful shoulder, was diagnosed with MTC and liver, lung and bone metastases. She died after 14 months due to progressive disease. The third patient, an 81-year-old woman with hyperparathyroidism, was coincidentally diagnosed with MTC after goitre surgery at the age of 67. When she was evaluated for rising calcitonin levels, a pheochromocytoma was found. RET mutation analysis confirmed a MEN2A syndrome. Current diagnostic procedures of MTC may include positron emission tomography with 18F-deoxyglucose (FDG-PET) and 18F-diphenylalanine (DOPA-PET). MTC is usually treated surgically. Tyrosine kinase inhibitors appear to offer potential new therapeutic possibilities.
authors.affiliation: Universitair Medisch Centrum Groningen, Groningen, Afd. Endocrinologie, the Netherlands.
authors.forename: Hans H G
authors.initials: HH
authors.lastname: Verbeek
authors.forename: Jan Willem B
authors.initials: JW
authors.lastname: de Groot
authors.forename: John T M
authors.initials: JT
authors.lastname: Plukker
authors.forename: Robert W M
authors.initials: RW
authors.lastname: Hofstra
authors.forename: Adrienne H
authors.initials: AH
authors.lastname: Brouwers
authors.forename: Michiel N
authors.initials: MN
authors.lastname: Kerstens
authors.forename: Thera P
authors.initials: TP
authors.lastname: Links
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D049268:Positron-Emission Tomography; D011720:Pyrazoles / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery*; D016606:Thyroid Nodule / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D016896:Treatment Outcome
chemical_list: C108123:4-amino-5-(4-methylphenyl)-7-(tert-butyl)pyrazolo(3,4-d)pyrimidine; D004791:Enzyme Inhibitors; D011720:Pyrazoles; D011743:Pyrimidines