ECEESPE2025 ePoster Presentations Thyroid (198 abstracts)
Endocrine follow-up during pregnancy for surgically treated medullary thyroid microcarcinoma
Zoran Gluvic 1 , Milena Lackovic 1 , Vladimir Samardzic 1 , Bojan Joksimovic 1 , Milos Marinkovic 1 , Marija Sinik 1 , Ilinka Popovic 1 , Sonja Zafirovic 2 & Esma R. Isenovic 2
1Zemun Clinical Hospital, Department of Endocrinology, Zemun, Belgrade, Serbia; 2Institute of Nuclear science “Vinca”, National Institute of REpublic of Serbia, Laboratory for radiobiology and molecular genetics, Belgrade, Serbia
JOINT639
Introduction: The impact of pregnancy on medullary thyroid microcarcinoma (MTmC) has not been extensively studied to date. Its management during pregnancy remains challenging. According to WHO grading criteria, the presence of at least one of the following criteria: mitotic index ≥5/mm2, Ki67 ≥5%, or tumor necrosis, qualifies MTmC as high grade, whereas MTmC lacking all three criteria is considered low-grade. The case report A pregnant woman, 31 years old, visits the outpatient Endocrine unit in the 6th week of pregnancy to check the quality of levothyroxine (LT4) substitution therapy. Her medical history revealed total thyroidectomy due to nodular thyroid disease and incidental histological finding of MTmC four months before pregnancy. Histological findings pointed out MTmC classical histological type, presented with low mitotic index, minimal amount of amyloid, and tumor-clear resection margins on the slide. Furthermore, lympho-vascular invasion and in-tumor necrosis were not detected. Biochemistry showed insufficient LT4 substitution in the first trimester of pregnancy (TSH 2.72), along with negative markers of MTmC recurrence or progression, and MEN syndrome presence (Calcitonin <0.5, CEA 0.8, PTH 17, Ca 2.45). The quality of LT4 substitution is improved during pregnancy and serial biochemistry follow-up on calcitonin levels were stationary (Calcitonin <0.5 at the 11th, 23rd, and 33th week of gestation). Genetic testing to rule out an inherited form of MTmC (RET gene, Thyroid carcinoma (HP:0002890, Neoplasm (HP:0002664 by Exome 2.0 Illumina panel) was negative.
Conclusion: Pregnancy did not increase the risk of a non-inherited MTmC recurrence in this 31-year-old patient with low-grade tumor characteristics. Based on the consistency of biochemical markers during pregnancy, there was no MTmC progression. The mainstay of thyroidectomized patients’ surveillance for MTmC is a careful monitoring and individualized management throughout pregnancy.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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