Pancreas as an Unusual Metastatic Site of Medullary Thyroid Carcinoma: A Case of Very Long-term Follow-up Under Prolonged Treatment with Somatostatin Analogues

Author:

Raia Salvatore123,Chiloiro Sabrina123,Giampietro Antonella13ORCID,Maratta Maria Grazia34,Attili Fabia35,Brizi Maria Gabriella67,Rufini Vittoria68,De Marinis Laura126,Pontecorvi Alfredo126,Rindi Guido6910,Schinzari Giovanni264,Bianchi Antonio126

Affiliation:

1. Internal Medicine, Endocrinology and Diabetes Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy

2. Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy

3. ENETS Center of Excellence, Rome, Italy

4. Medical Oncology Unit, Fondazione Policlinico Gemelli, IRCCS, Rome, Italy

5. CEMAD Digestive Disease Center, Fondazione Policlinico Gemelli, IRCCS, Rome, Italy

6. ENETS Center of Excellence, Rome, Italy

7. Department of Radiology, Radiation Oncology and Hematology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy

8. Nuclear Medicine Unit, Radiation Oncology and Hematology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy

9. Anatomic Pathology Unit, Department of Woman and Child Health Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy

10. Section of Anatomic Pathology, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy

Abstract

Background: Pancreatic metastases from medullary thyroid carcinoma (MTC) are exceptional. Imaging and treatment based on somatostatin receptors may play a role, though the evidence is unconvincing. Case Presentation: We have, herein, documented a unique case of metastatic MTC, where pancreatic metastasis was identified by 68Ga-PET/CT, with the disease showing very slow progression during treatment with lanreotide autogel. A 51-year-old woman underwent total thyroidectomy for goiter in 2000, with a postoperative diagnosis of MTC. Due to persistent disease, somatostatin analogues (SSA) treatment commenced in 2005, following a positive acute octreotide test. In 2012, a pathology-confirmed pancreatic metastasis was diagnosed via 68Gallium-positron emission tomography (68Ga-PET/CT). The disease progressed very slowly over 17 years of SSA treatment. Conclusion: This uncommon case of pancreatic metastasis from MTC indicates that nuclear medicine techniques might offer valuable additional information. Extended treatment with lanreotide autogel appears to correlate with very slow disease progression in selected patients.

Publisher

Bentham Science Publishers Ltd.

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