Resumen

URDIALES VIEDMA, M. et al. Metástasis óseas, primera manifestación clínica de un carcinoma productor de calcitonina. Oncología (Barc.) [online]. 2005, vol.28, n.4, pp.26-30. ISSN 0378-4835.

PURPOSE: Thyroid medullary carcinoma comprises between 5 and 10 % of all thyroid cancers. The most common clinical presentation is a thyroid mass. Study of a case with bone metastases. CASE REPORT: A 32 year old man with pain due to multiple bone metastases. A bone marrow biopsy disclosed a carcinoma immunologically positive to calcitonin and carcinoembryonic antigen. Serum level of both, calcitonin and carcinoembryonic antigen, were very high. The patient was treated with chemotherapy and radiotherapy, and died 12 months later. DISCUSSION: Distant metastases are not a usual presentation of thyroid medullary carcinoma. Patients younger than 45 years have a better survival, but bone metastases correlate with a very bad prognosis. Immunohistochemistry and blood determination of carcinoembryonic antigen and calcitonin are important diagnostic tools. CONCLUSION: Atypical presentation of a thyroid medullary carcinoma in a young man with bone metastases and short survival. Immunohistochemistry is very useful to establish the origin of the primary tumour in these metastases. In the event of an unexplained plasma rise of calcitonin and/or carcinoembryonic antigen, it is mandatory to rule out a thyroid medullary carcinoma.

Palabras clave : Thyroid; Bone marrow; Medullary carcinoma; Metastases; Calcitonin; Carcinoembryonic antigen.

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