ArticleCureus2025
A Case of Micro-medullary Thyroid Carcinoma Presenting as Cancer of Unknown Primary.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Management of ectopic Cushing syndrome in medullary thyroid carcinoma: from case reports to systematic literature review.Frontiers in endocrinology · 2026Pooled it
- FGFR1 signaling in rheumatoid arthritis: Mechanisms of bone destruction and therapeutic targeting (Review).International journal of molecular medicine · 2026Review
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Cancer of unknown primary (CUP) with neuroendocrine features is classified as a favorable subset, and treatment is recommended based on the grade of the neuroendocrine tumor (NET). Although rare, medullary thyroid carcinoma (MTC) can present as CUP with neuroendocrine features and should be carefully considered as a crucial differential diagnosis in such cases. A 65-year-old man with no relevant medical history presented with a gradually enlarging left cervical mass. Laboratory evaluation revealed hypokalemia due to adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome. Contrast-enhanced computed tomography (CT) demonstrated multiple lymphadenopathies, hepatic masses, and bilateral pulmonary ground-glass opacities. A biopsy of a cervical lymph node revealed a neuroendocrine tumor grade 2 (NET G2), but the primary tumor was undetectable on imaging. Elevated serum calcitonin and thyroid ultrasound identified a small left thyroid nodule, fine-needle aspiration, and calcitonin immunostaining on the lesion pathologically revealed MTC. Given the rapidly progressive disease, vandetanib was initiated while awaiting molecular testing for rearranged during transfection (RET)-alteration. Following the detection of the RET M918T mutation, treatment was switched to selpercatinib, and rapid tumor response and endocrine symptom resolution were observed. This case highlights the importance of evaluating serum calcitonin, specifically in patients with neuroendocrine carcinoma of unknown primary, where MTC should be considered as a critical differential diagnosis. Thyroid ultrasound should be performed to identify even small lesions of medullary thyroid carcinoma (micro-MTC). Identification of MTC not only leads to targeted therapies that may improve prognosis, but also allows for genetic risk assessment and early intervention in family members when multiple endocrine neoplasia type 2 (MEN2) is suspected.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.