Gepubliceerd op: 10-09-2010
Citeer dit artikel als:
 Ned Tijdschr Geneeskd. 2010;154:A1818
Klinische les

Hans H.G. Verbeek

,

Jan Willem B. de Groot

,

John T.M. Plukker

,

Robert M.W. Hofstra

,

Adrienne H. Brouwers

,

Michiel N. Kerstens

en

Thera P. Links

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 pheochromcytoma 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.

Conflict of interest: none declared. Financial support: none declared.

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