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Michael Dick and Michael Croxson

syndrome . Canadian Journal of Gastroenterology 1999 13 767 – 770 . ( https://doi.org/10.1155/1999/810264 ) 7 Zelissen PM Bast EJ Croughs RJ . Associated autoimmunity in Addison’s disease . Journal of Autoimmunity 1995 8 121 – 130

Open access

Navira Samad and Ian Fraser

Kang SH Baeg MK Oh HJ 2014 Case of inappropriate ADH syndrome: hyponatremia due to polyethylene glycol bowel preparation . World Journal of Gastroenterology 20 12350 – 12354 . ( doi:10.3748/wjg.v20.i34.12350 ) 6 Hasan AG Brown

Open access

Bernardo Marques, Raquel G Martins, Guilherme Tralhão, Joana Couto, Sandra Saraiva, Henrique Ferrão, João Ribeiro, Jacinta Santos, Teresa Martins, Ana Teresa Cadime and Fernando Rodrigues

.1530/EJE-12-0418 ) 3 Li T-T Qian Z-R Wan J Qi X-K Wu B-Y. Classification, clinicopathologic features and treatment of gastric neuroendocrine tumors . World Journal of Gastroenterology 2014 20 118 – 125 . ( https://doi.org/10.3748/wjg

Open access

Andrea Pucci, Wui Hang Cheung, Jenny Jones, Sean Manning, Helen Kingett, Marco Adamo, Mohamed Elkalaawy, Andrew Jenkinson, Nicholas Finer, Jacqueline Doyle, Majid Hashemi and Rachel L Batterham

standardization, acclimatization, and sample processing affect gut hormone levels and appetite in humans . Gastroenterology 136 2115 – 2126 . ( doi:10.1053/j.gastro.2009.02.047 ) Lee WJ Pok EH Almulaifi A Tsou JJ

Open access

Adriana de Sousa Lages, Isabel Paiva, Patrícia Oliveira, Francisco Portela and Francisco Carrilho

Ito S Ogawa Y Kobayashi M Hanazaki K 2013 Diagnosis and management of insulinoma . World Journal of Gastroenterology 19 829 – 837 . ( doi:10.3748/wjg.v19.i6.829 ) 3 Davi MV Pia A Guarnotta V Pizza G Colao A

Open access

I Huguet, C Lamas, R Vera, A Lomas, R P Quilez, A Grossman and F Botella

Summary

Neuroendocrine tumours (NETs) are a heterogeneous group of neoplasms whose management can be problematic. In many cases, multiple tumours may occur in the same patient or his or her family, and some of these have now been defined genetically, although in other cases the underlying gene or genes involved remain unclear. We describe a patient, a 63-year-old female, who was diagnosed with a medullary thyroid carcinoma (MTC), which was confirmed pathologically after thyroidectomy, but whose circulating calcitonin levels remained elevated after thyroidectomy with no evidence of metastatic disease. Subsequently, an entirely separate and discrete duodenal NET was identified; this was 2.8 cm in diameter and was removed at partial duodenectomy. The tumour stained immunohistochemically for calcitonin, and its removal led to persistent normalisation of the circulating calcitonin levels. There was no germline mutation of the RET oncogene. This is the first identification of a duodenal NET secreting calcitonin and also the first demonstration of a second tumour secreting calcitonin in a patient with MTC. We suggest that where calcitonin levels remain high after removal of a MTC a search for other NETs should be conducted.

Learning points

  • NETs are a complex and heterogeneous group of related neoplasms, and multiple tumours may occur in the same patient.
  • Calcitonin can be produced ectopically by several tumours outside the thyroid.
  • Persistently elevated calcitonin levels after removal of a MTC may not necessarily indicate persisting or metastatic disease from the tumour.
  • The real prevalence of calcitonin-producing NETs may be underestimated, as serum determination is only recommended in the diagnosis of pancreatic NETs.

Open access

Peter Novodvorsky, Emma Walkinshaw, Waliur Rahman, Valerie Gordon, Karen Towse, Sarah Mitchell, Dinesh Selvarajah, Priya Madhuvrata and Alia Munir

Complications of bariatric surgery: dumping syndrome, reflux and vitamin deficiencies . Best Practice and Research Clinical Gastroenterology 28 741 – 749 . ( https://doi.org/10.1016/j.bpg.2014.07.010 ) 2 Welbourn RSP Finlay I Sareela A Somers

Open access

Laila Ennazk, Ghizlane El Mghari and Nawal El Ansari

Vege SS 2006 Diagnosis of autoimmune pancreatitis: the Mayo Clinic experience . Clinical Gastroenterology and Hepatology 4 1010 – 1016 . ( doi:10.1016/j.cgh.2006.05.017 ) 5 Endo T Takizawa S Tanaka S Takahashi M Fujii H

Open access

Benjamin G Challis, Chung Thong Lim, Alison Cluroe, Ewen Cameron and Stephen O’Rahilly

Himbele J Vranjican Z Barsic B 2006 McKittrick-Wheelock syndrome: a rare cause of diarrhoea . European Journal of Gastroenterology & Hepatology 18 557 – 559 . Bamford JK Galbraith HJ Pender BW

Open access

Marcela Rodríguez Flores, Ruth Carmina Cruz Soto, Verónica Vázquez Velázquez, Reina Ruth Soriano Cortés, Carlos Aguilar Salinas and Eduardo García García

Vidal J Corcelles R Jimenez A Flores L Lacy AM . Metabolic and bariatric surgery for obesity . Gastroenterology 2017 152 . ( https://doi.org/10.1053/j.gastro.2017.01.051 ) 3 Hanaire H Bertrand M Guerci B Anduze Y Guillaume E