Incidental diagnosis of medullary thyroid carcinoma due to persistently elevated procalcitonin in a patient with COVID-19 pneumonia:A case report  

作　　者：Amitabha Saha Madhusha Mukhopadhyay Souvik Paul Arnab Bera Tapas Bandyopadhyay 

机构地区：[1]Department of Internal Medicine,Critical Care Medicine,Medica Superspecialty Hospital,Kolkata 700099,West Bengal,India [2]Department of Internal Medicine,Medica Superspecialty Hospital,Kolkata 700099,West Bengal,India [3]Department of Critical Care Medicine,Medica Superspecialty Hospital,Kolkata 700099,West Bengal,India

出　　处：《World Journal of Clinical Cases》2022年第20期7171-7177,共7页世界临床病例杂志

摘　　要：BACKGROUND Procalcitonin(Pct)is a common biomarker in clinical practice,especially in the era of coronavirus disease 2019(COVID-19)infection.Although it is frequently used for the diagnosis and prognostication of bacterial infections or sepsis,it is also elevated in a few other conditions,including medullary thyroid carcinoma(MTC).CASE SUMMARY A 43-year-old female presented with moderately severe COVID-19 pneumonia in April 2021.She gradually recovered clinically;however,despite normalization of other inflammatory markers,Pct levels remained persistently elevated.Further workup identified the cause as left lobe MTC with locoregional metastasis.Calcitonin levels were high,and carcinoembryonic antigen levels were normal.The patient underwent total thyroidectomy and neck dissection,which was followed by another radical neck dissection due to residual disease.Currently,she is doing well,nearly having completed her course of external beam radiotherapy with no recurrence.Pct is well documented as a screening tool for MTC,especially because of its stable nature compared to calcitonin in the community settings.It is important to keep in mind the differential diagnosis of MTC in patients with persistently elevated Pct levels despite normal levels of other acute phase reactants.To the best of our knowledge,this is the first report from Asia of such an incidental diagnosis of MTC due to persistently elevated Pct levels in a patient with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.CONCLUSION Persistently elevated Pct levels can occur in any pro-inflammatory state including infections,sepsis,or acute respiratory distress syndrome.In the current setting,SARS-CoV-2 infection is one such clinical scenario,and in rare situations of persistent elevation,MTC may need to be ruled out.

关 键 词：COVID-19 Medullary thyroid carcinoma PROCALCITONIN SARS-COV-2 CALCITONIN Case report 

分 类 号：R563.1[医药卫生—呼吸系统] R736.1[医药卫生—内科学]