[Sporadic C-cell hyperplasia associated with multinodular goiter]

INTRODUCTION: C cell hyperplasia may arise in a familial setting, associated to MEN2 syndromes, or sporadic, associated to other thyroid diseases. Its prevalence in the sporadic form, as well as its biological significance, need to be determined to date. Sporadic C cell hyperplasia may be associated to elevated serum calcitonin levels, and routinary calcitonin screening tests on the search of early medullary carcinomas, have born to an increase of its diagnosis. MATERIALS AND METHODS: We report herein the case of a 47-years old female, submitted to total thyroidectomy for nodular goiter, with slightly increased serum calcitonin levels and positive pentagastrin test. Familial history was negative for endocrinopathies. CASE REPORT: Histological examination revealed in the setting of a multinodular goiter, the occurrence of C cell hyperplasia, demonstrated by means of calcitonin immunoistochemistry, in the absence of foci of medullary carcinoma. Morphological features (no atypia) were consistent with a sporadic physiologic form of C cell hyperplasia, as opposed to neoplastic C cell hyperplasia in the context of MEN2. DISCUSSION: The prevalence of C cell hyperplasia is not well defined, and differently from the familial form, its progression to sporadic medullary carcinoma should still be proven. Therefore its observation in a sporadic form, as in the present case, do not modify the clinical and therapeutic approach in affected patients.