Ectopic calcitonin secretion in a woman with large cell neuroendocrine lung carcinoma

Cvijović, Goran; Micić, Dragan; Kendereški, Aleksandra; Zorić, Svetlana; Šumarac-Dumanović, Mirjana; Tatic, Svetislav; Trivić, Aleksandar; Pejkovic-Stamenkovic, Danica; Jeremić, Danka

doi:10.14310/horm.2002.1447

Cited by 8 publications

(10 citation statements)

References 45 publications

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“…Hypersecretion of calcitonin by NENs is rare; in fact, in functional NENs, calcitonin secretion is less common than other hormone secretions causing endocrine paraneoplastic syndromes (79). Table 2 summarizes the main features of the calcitonin.-secreting NENs reported in the literature (1,5,7,40,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94). Pancreatic, laryngeal and lung NENs are most frequently associated with hypercalcitoninemia, but calcitonin secretion has also been described in duodenal, esophageal, cutaneous and paranasal NENs.…”

Section: False Positives and False Negativesmentioning

confidence: 99%

ENDOCRINE TUMOURS: Calcitonin in thyroid and extra-thyroid neuroendocrine neoplasms: the two-faced Janus

Giannetta

Guarnotta

Altieri

et al. 2020

European Journal of Endocrinology

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An increased calcitonin serum level is suggestive of a medullary thyroid cancer (MTC), but is not pathognomonic. The possibility of false positives or other calcitonin-secreting neuroendocrine neoplasms (NENs) should be considered. Serum calcitonin levels are generally assessed by immunoradiometric and chemiluminescent assays with high sensitivity and specificity; however, slightly-moderately elevated levels could be attributable to various confounding factors. Calcitonin values >100 pg/mL are strongly suspicious of malignancy, whereas in patients with moderately elevated values (10-100 pg/mL) a stimulation test may be applied to improve diagnostic accuracy. Although the standard protocol and the best gender-specific cut-offs for calcium stimulated calcitonin are still controversial, the fold of the calcitonin increase after stimulation seems to be more reliable. Patients with MTC show stimulated calcitonin values at least 3-4 times higher than the basal values, whereas calcitonin-secreting NENs can be distinguished from a C-cell disease by the absence of or <2-fold response to stimulation. The measurement of calcitonin in fine-needle aspirate washout (FNA-CT) and calcitonin immunocytochemical staining from thyroid nodules are ancillary methods that may significantly improve MTC diagnosis. The present review examines the gray areas in the interpretation of calcitonin measurement in order to provide a tool to clarify the origin of calcitonin secretion and differentiate the behavior of the two-faced Janus of neuroendocrinology: intra-thyroid (MTC) and extra-thyroid NENs.

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Section: False Positives and False Negativesmentioning

confidence: 99%

ENDOCRINE TUMOURS: Calcitonin in thyroid and extra-thyroid neuroendocrine neoplasms: the two-faced Janus

Giannetta

Guarnotta

Altieri

et al. 2020

European Journal of Endocrinology

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“…1 However, several other neuroendocrine tumors (NETs) can also release calcitonin, including pheochromocytomas, neuromas and lung, breast, prostate, and colorectal carcinomas. 2,3 Calcitonin-secreting pancreatic endocrine tumors (CTsPETs) have been described as extremely rare. 4 We report 2 consecutive cases of CTsPETs found during the evaluation of patients with hypercalcitoninemia and thyroid nodules.…”

Section: Introductionmentioning

confidence: 99%

Extrathyroidal Calcitonin Secreting Tumors

et al. 2016

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Calcitonin is the hallmark of medullary thyroid carcinoma. However, extrathyroidal neuroendocrine tumors can also release calcitonin.We report 2 cases of calcitonin-secreting pancreatic tumors found in asymptomatic patients with thyroid nodules referred to our center within 11 months.Case 1: A man initially referred for thyroid nodule characterization was found to have hypercalcitoninemia (>200 pg/mL) during non-neoplastic fine-needle aspiration.Case 2: A woman evaluated for liver metastasis was found to have hypercalcitoninemia and multinodular goiter.Our research emphasizes that marked hypercalcitoninemia in the presence of thyroid nodules is not necessarily due to medullary thyroid carcinoma; awareness of this could avoid unnecessary thyroidectomy. The lack of specific symptoms related to hypercalcitoninemia may be the reason that the prevalence of calcitonin-secreting pancreatic tumors is underestimated.

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“…Presenting symptoms included metabolic alkalosis with hypokalaemia, hypocalcaemia, hypomagnesaemia, hypophosphataemia, hyperglycaemia and profound diarrhoea (Coners et al 2011). There are several other cases of ectopic calcitonin secretion by SCLC, LCLC or lung carcinoids (Kelley et al 1994, Machens et al 2000, Cvijovic et al 2013.…”

Section: Less Common Endocrine Pns Secondary To the Secretion Of Peptmentioning

confidence: 99%

Paraneoplastic endocrine syndromes

Dimitriadis

Angelousi

Weickert

et al. 2017

Endocrine-Related Cancer

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The majority of neoplasms are responsible for symptoms caused by mass effects to surrounding tissues and/or through the development of metastases. However, occasionally neoplasms, with or without endocrine differentiation, acquire the ability to secrete a variety of bioactive substances or induce immune cross-reactivity with the normal tissues that can lead to the development of characteristic clinical syndromes. These syndromes are named endocrine paraneoplastic syndromes when the specific secretory components (hormones, peptides or cytokines) are unrelated to the anticipated tissue or organ of origin. Endocrine paraneoplastic syndromes can complicate the patient's clinical course, response to treatment, impact prognosis and even be confused as metastatic spread. These syndromes can precede, occur concomitantly or present at a later stage of tumour development, and along with the secreted substances constitute the biological 'fingerprint' of the tumour. Their detection can facilitate early diagnosis of the underlying neoplasia, monitor response to treatment and/or detect early recurrences following successful initial management. Although when associated with tumours of low malignant potential they usually do not affect long-term outcome, in cases of highly malignant tumours, endocrine paraneoplastic syndromes are usually associated with poorer survival outcomes. Recent medical advances have not only improved our understanding of paraneoplastic syndrome pathogenesis in general but also enhanced their diagnosis and treatment. Yet, given the rarity of endocrine paraneoplastic syndromes, there is a paucity of prospective clinical trials to guide management. The development of well-designed prospective multicentre trials remains a priority in the field in order to fully characterise these syndromes and provide evidence-based diagnostic and therapeutic protocols.

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Ectopic calcitonin secretion in a woman with large cell neuroendocrine lung carcinoma

Cited by 8 publications

References 45 publications

ENDOCRINE TUMOURS: Calcitonin in thyroid and extra-thyroid neuroendocrine neoplasms: the two-faced Janus

ENDOCRINE TUMOURS: Calcitonin in thyroid and extra-thyroid neuroendocrine neoplasms: the two-faced Janus

Extrathyroidal Calcitonin Secreting Tumors

Paraneoplastic endocrine syndromes

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