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98.2.23--Case Presentation MTC
- A 63 years old male with complaint of diarrhea since 7 years ago
- In 1387 ( 11 years ago) ,the patient was referred to endocrinologist due to left thyroid enlargement and a 2.5 *1.5 cm nodule was detected in left thyroid lobe and FNA was done.
- FNA report was benign follicular nodule and repeated FNA in annual F/u was the same.
- After 4 years (1391) size of nodule increased (3*3cm) and FNA of nodule documented follicular lesion and surgical resection was recommended.
- In 1391, severe watery diarrhea [(8-10( times/day, high volume, without abdominal pain and weight loss ] was started.
- In 1392,left lobectomy and isthmectomy was done and according to pathology report of MTC, total thyroidectomy was performed 2 weeks later.
- 2 weeks after surgery, tumor markers of MTC show normal calcitonin (Ctn) with high CEA level.
- After surgery , diarrhea improved. in annual F/U after operation , CEA and Ctn level and imaging w/u were normal until 1396.
- In 1396, diarrhea recurred and the patient complained of watery diarrhea 3-4 times/daily , high volume without abdominal pain, after meals.
Serum Ctn was increased to 55 pg/ml.
- Imaging w/u showed a 27*18 mm nodule in bed of left lobe thyroid and FNA documented a benign follicular nodule.
- regarding to elevated tumor marker and symptomatic (diarrhea) the patient underwent left cervical mass resection(1396/11) pathology and IHC showed MTC.
- Diarrhea disappeared until 4 months after
surgery.
