Case Report: Medullary Thyroid Cancer Workup Initiated by Unexpectedly High Procalcitonin Level-Endocrine Training Saves Life in the COVID-19 Unit

Front Endocrinol (Lausanne). 2021 Oct 11:12:727320. doi: 10.3389/fendo.2021.727320. eCollection 2021.

Abstract

Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a novel coronavirus that has caused a worldwide pandemic. The majority of medullary thyroid cancers present as a thyroid nodule. At the time of diagnosis, cervical lymph nodes and distant metastases are frequently detected.

Case report: Here, we present a case of a 46-year-old man with coronavirus disease (COVID) pneumonia, who had persistently high serum procalcitonin levels despite normal C-reactive protein levels. The attending infectologist happened to be a colleague who spent some time, as part of her internal medicine rotation, in the Endocrine Ward and recalled that medullary thyroid cancer might be the cause. This led to the timely workup and treatment of the medullary cancer.

Keywords: calcitonin; endocrine rotation; medullary thyroid cancer; procalcitonin; severe acute respiratory syndrome coronavirus 2.

Publication types

  • Case Reports

MeSH terms

  • Biomarkers, Tumor / blood
  • C-Reactive Protein / biosynthesis
  • COVID-19 / complications*
  • Carcinoma, Neuroendocrine / blood*
  • Carcinoma, Neuroendocrine / complications
  • Carcinoma, Neuroendocrine / diagnosis*
  • Endocrinology / methods*
  • Humans
  • Incidental Findings
  • Lymph Nodes / pathology
  • Male
  • Middle Aged
  • Procalcitonin / blood*
  • SARS-CoV-2
  • Thyroid Neoplasms / blood*
  • Thyroid Neoplasms / complications
  • Thyroid Neoplasms / diagnosis*
  • Thyroid Nodule

Substances

  • Biomarkers, Tumor
  • Procalcitonin
  • C-Reactive Protein

Supplementary concepts

  • Thyroid cancer, medullary