Erschienen in:
24.10.2018
Neuroendocrine neoplasms – think about it and choose the most appropriate diagnostic and therapeutic steps
verfasst von:
Christian A. Koch, S. Petersenn
Erschienen in:
Reviews in Endocrine and Metabolic Disorders
|
Ausgabe 2/2018
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Excerpt
We are pleased to present the second issue on neuroendocrine neoplasms (NEN). Often, NEN are also referred to as “zebras” because of their rarity, and we would like to expand this thought into “black swans,” a term that is based on an ancient perception that presumed black swans did not exist, but had to be changed once they were discovered in nature. This should teach us that any system of thought should constantly be re-evaluated. It is understandable that humans usually harbor some anxiety towards the unknown and that this angst is more pronounced in more conservative communities than in progressive ones. Discoveries are usually made by thinking “outside of the box.” For instance, excessively high serum calcitonin levels could be alarming for an existing NEN. The odds of a possible NEN would call for a neck examination to search for medullary thyroid carcinoma and in some cases thyroidectomy would be performed without identifying any tumor [
1], because calcitonin secretion occurs ectopically from an unsuspected NEN [
2‐
8]. More recently, the presence of macrocalcitonin as a pitfall in the endocrine laboratory assessment has been discovered [
9]. Similar to other macrohormones such as macroprolactin, a macro-thyroid stimulating hormone, macrocalcitonin has neglectable biological activity [
9‐
11]. …