title: [Reintervention in C-cell carcinoma].
abstract: Cervical re-exploration in persistent medullary thyroid cancer usually fails to normalize serum calcitonin levels, which is the most sensitive criterion of tumour-free status (2 out of 21 patients in our re-exploration series). Positive lymph nodes - even at an early tumour stage - seem much more important (postoperative normal serum calcitonin: 86% in the occult tumour group, 71% in patients with palpable primary tumour and negative lymph nodes, as opposed to only 18% with a palpable cervical mass and positive lymph nodes). However, local re-exploration in case of persistent medullary thyroid cancer seems to offer a possible curative chance for the control of recurrence, especially after inadequate primary surgery. In cases without visible distant metastases a marked reduction in serum calcitonin level may be expected (21% of the preoperative level for stages N1 and N2 and 16% for stage N3 on average). In patients with elevated calcitonin levels after stimulation as sole indicator of persistent tumour the indication for reoperation should be handled cautiously. Thus, in 3 out of 5 patients with occult medullary thyroid cancer diagnosed only on the basis of venous sampling who were subjected to multiple cervical re-explorations, distant metastases were subsequently found during follow-up.
mesh_terms: D002116:Calcitonin / Q000097:blood; D002277:Carcinoma / Q000097:blood / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D009377:Multiple Endocrine Neoplasia / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000097:blood / Q000601:surgery*
chemical_list: D002116:Calcitonin
vernacular_title: Reintervention beim C-Zell-Karzinom.