eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2016-01-08 4 1 8 11 10.12691/ajmcr-4-1-3 AJMCR2016413 article Balakrishnan valliyot 1 Saroshkumar KK 1 Sarin SM 1 Kadeeja beevi B 1 Nirmal mathew alex nirmal47@gmail.com 1 Tency joshu thomas 1 Department of Medicine, ACME Pariyaram, Kannur, India Medullary Thyroid Carcinoma (MTC) is a rare thyroid tumor that arises from neural crest-derived Calcitonin producing Para follicular C cells and accounts for approximately 4 % of thyroid malignancies. This neuroendocrine tumor typically is an aggressive cancer, with secretion of several neuro-humoral mediators. We report a case of 49 year old male patient who presented with episodes of chest discomfort and abdominal pain associated with loud screaming of unknown etiology, on evaluation found to have Medullary Thyroid Carcinoma as its cause. MTC usually present as palpable firm to hard thyroid nodules or enlargement of regional lymph nodes. Since the systemic symptoms of MTC are nonspecific, it is challenging to diagnose MTC when patients first presents with systemic symptoms as in our patient. This case is reported to highlight the unusual presentation of this rare thyroid tumor and to emphasize the need for meticulous clinical examination and high index of suspicion to diagnose it. http://pubs.sciepub.com/ajmcr/4/1/3/ajmcr-4-1-3.pdf medullary carcinoma thyroid thyroid malignancy neurohormones