Pancreas, An Unusual Metastatic Site In A Long-term Indolent Surviving Case, Under Somatostatin Analogues Therapy, Of Medullary Thyroid Carcinoma: A Case Report And Review Of Cases Documented In Literature

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

doi:10.1530/endoabs.90.EP628

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Endocrine Abstracts (2023) 90 EP628 | DOI: 10.1530/endoabs.90.EP628

ECE2023 Eposter Presentations Endocrine-related Cancer (80 abstracts)

Pancreas, An Unusual Metastatic Site In A Long-term Indolent Surviving Case, Under Somatostatin Analogues Therapy, Of Medullary Thyroid Carcinoma: A Case Report And Review Of Cases Documented In Literature

Salvatore Raia ¹ , Sabrina Chiloiro ¹ , Antonella Giampietro ¹ , Maria Grazia Maratta ² , Giovanni Schinzari ² , Fabia Attili ³ , Maria Gabriella Brizi ⁴ , Vittoria Rufini ⁵ , Laura De Marinis ¹ , Alfredo Pontecorvi ¹ , Guido Rindi ⁶ & Antonio Bianchi ¹

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Author affiliations

¹Agostino Gemelli University Policlinic, Endocrinology, Rome, Italy; ²Agostino Gemelli University Policlinic, Oncology, Rome, Italy; ³Agostino Gemelli University Policlinic, Digestive Endoscopy, Rome, Italy; ⁴Agostino Gemelli University Policlinic, Radiology, Rome, Italy; ⁵Agostino Gemelli University Policlinic, Nuclear Medicine, Rome, Italy; ⁶Agostino Gemelli University Policlinic, Anatomic Pathology, Rome, Italy.

Medullary thyroid carcinoma (MTC) accounts for 1%–2% of thyroid cancers and has a variable clinical course. MTCs present with locoregional metastasis in 50% of patients and distant metastasis in 10% to 15% at the time of initial diagnosis. The lungs, liver, and bone are common metastatic sites, and distant metastasis is known to be a poor prognostic factor for long-term oncologic outcomes. We present the long course case, under somatostatin analogues (SSA) therapy, of a 72 years old woman, who underwent total thyroidectomy surgery for multinodular goiter in 2000 with subsequent histologic diagnosis of MTC RET wild type and histologic typing in 2022 of a pancreatic metastasis from known medullary thyroid carcinoma. Since 2005 she was treated with lanreotide autogel (ATG) 120 mg/every 28 days. In 2014 lanreotide ATG was administered with high frequency (every 14 days) for radiological progression. The use of SSA instead of tyrosine kinase inhibitors (TKI) was preferred in light of the symptom-free clinical condition. This case constitutes, to our knowledge, the seventh reported case of pancreatic metastasis from MTC in the literature and we performed a review of the other reported clinical cases. The present report is also significant given the few described recurrent MTC cases in a patient with clinical stable disease with slow radiological progression after surgery and under long-term SSA therapy. This case may suggest that prolonged SSA therapy is beneficial in MTC asymptomatic patients with slow radiological progression; further confirmatory evidence is required.