Endocrinol Metab.  2015 Jun;30(2):221-225. 10.3803/EnM.2015.30.2.221.

A Calcitonin-Negative Neuroendocrine Tumor Derived from Follicular Lesions of the Thyroid

• Kim GY
• Park CY
• Cho CH
• Park JS
• Jung ED
• Jeon EJ

• KMID: 2282014
• DOI: http://doi.org/10.3803/EnM.2015.30.2.221

Abstract

Neuroendocrine lesions of the thyroid are rare. The most common types are medullary thyroid carcinomas (MTCs) and C-cell hyperplasia. MTCs originate from thyroid parafollicular cells that secrete calcitonin which serves as a serum marker of MTCs. Here, the rare case of a calcitonin-negative neuroendocrine tumor (NET) derived from follicular lesions of the thyroid is described. A 34-year-old man presented at our hospital for the surgical management of an incidental thyroid nodule that was observed on an ultrasound sonography (USG) of the neck. Initially, USG-guided aspiration cytology was performed, and a MTC was suspected. The expressions of thyroglobulin and thyroid transcription factor-1, which are thyroid follicular cell markers, and synaptophysin and chromogranin A, which are neuroendocrine markers, was confirmed following surgical pathology. However, the staining of calcitonin, a marker of MTCs, was not observed. A nonmedullary NET of the thyroid is uncommon, and the distinction between calcitonin-negative NETs and MTCs of the thyroid may be important due to differences in their clinical courses and management.

Keyword

Calcitonin; Carcinoma, medullary; Neuroendocrine tumors

MeSH Terms

Adult
Calcitonin
Carcinoma, Medullary
Chromogranin A
Humans
Hyperplasia
Neck
Neuroendocrine Tumors*
Pathology, Surgical
Synaptophysin
Thyroglobulin
Thyroid Gland*
Thyroid Neoplasms
Thyroid Nodule
Ultrasonography
Biomarkers
Calcitonin
Chromogranin A
Synaptophysin
Thyroglobulin

Figure

• 

  Fig. 1 Thyroid ultrasound sonography showing an approximately 0.88×0.57×0.88 cm-sized hypoechoic nodule (A, yellow arrow) with increased vascularity (B) of the right lobe.

• 

  Fig. 2 Histologic findings showing a well-differentiated neuroendocrine tumor (A, H&E stain, ×100) with calcitonin-negative immunohistochemical staining (B, ×200) of tumor cells.

• 

  Fig. 3 Immunohistochemistry findings showing strong positive chromogranin A (A, ×100) and synaptophysin (B, ×100) staining of the tumor cells.

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