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

Salvatore Raia; Sabrina Chiloiro; Antonella Giampietro; Maria Grazia Maratta; Fabia Attili; Maria Gabriella Brizi; Vittoria Rufini; Laura De Marinis; Alfredo Pontecorvi; Guido Rindi; Giovanni Schinzari; Antonio Bianchi

doi:10.2174/0118715303277049231229051823

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

Endocr Metab Immune Disord Drug Targets. 2024 Jan 26. doi: 10.2174/0118715303277049231229051823. Online ahead of print.

Authors

Salvatore Raia^{1

2

3}, Sabrina Chiloiro^{1

2

3}, Antonella Giampietro^{1

3}, Maria Grazia Maratta^{3

4}, Fabia Attili^{3

5}, Maria Gabriella Brizi^{3

6}, Vittoria Rufini^{3

7}, Laura De Marinis^{1

2

3}, Alfredo Pontecorvi^{1

2

3}, Guido Rindi^{3

8

9}, Giovanni Schinzari^{2

3

4}, Antonio Bianchi^{1

2

3}

Affiliations

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.
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 Department of Radiology, Radiation Oncology and Hematology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
⁷ Nuclear Medicine Unit, Radiation Oncology and Hematology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
⁸ Anatomic Pathology Unit, Department of Woman and Child Health Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
⁹ Section of Anatomic Pathology, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.

PMID: 38284724
DOI: 10.2174/0118715303277049231229051823

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.

Keywords: clinical; diagnosis; medullary thyroid carcinoma (MTC); multinodular goiter (MNG); pancreatic metastasis; somatostatin receptor ligands.

Publication types

Case Reports