Diarrhea as first manifestation of a medullary thyroid carcinoma

Background: With the differential diagnosis ofa diarrhea a lot of causes ha s to be considered. In very rare cases diarrhea can be the first symptom of a medullary thyroid carcinoma (MTC). Case Report: A 28-year-old patient came to the admission department because of persisting diarrhea. A computerized tomography revealed multiple hepati c and pulmonary metastases. A medullary thyreoid carcinoma was found as the cause of it. The serum calcitonin values were highly increased, later the carcinoembryonal antigen (CEA), too. Sandostatin((R)), a radioimmune therap y ((131)J-anti-CEA antibody) and adriamycin were therapeutically applied. T he patient died 24 months after the occurrence of the first symptoms. Conclusion: In case of persisting diarrhea the differential diagnosis of a medullary thyroid carcinoma must be taken into consideration and a calciton in determination has to be arranged. Yet, typical symptoms like struma nodo sa, swollen neck lymph nodes or a CEA increase can still be missing in the initial phase.