Early liver metastases in patients with medullary carcinoma of the thyroid gland.
In 13 patients who had been thyroidectomized for medullary carcinoma (MCT), basal and pentagastrin-stimulated immunoreactive calcitonin (iCT) concentrations were measured in a peripheral vein and concomitantly in hepatic veins as well as in the superior and inferior caval veins. The basal concentrations of iCT in serum from the antecubital vein ranged from normal values (less than 0.50 micrograms/1) to grossly elevated (greater than 100 micrograms/1). Intravenous pentagastrin injections (0.5 micrograms/kg) stimulated transiently calcitonin secretion in all patients and peak concentrations occurred in peripheral venous blood and in the inferior caval vein after 3 to 5 minutes. In all patients peak iCT values in the hepatic vein occurred at 1 to 2 minutes and were much higher than in samples taken from other veins. Only three patients showed metastases to liver as judged by conventional clinical and laboratory examinations. Two patients with nonthyroid, malignant disease did not show an increase in serum iCT concentration of hepatic veins. The authors conclude that MCT may spread early to the liver. The presence of liver metastases is an important prognostic factor in patient evaluation and can be demonstrated by measuring iCT in hepatic veins before and during pentagastrin stimulation.
Gautvik
K M
KM
Institute of Medical Biochemistry, Rikshospitalet, University of Oslo, Norway.
Talle
K
K
Hager
B
B
Jørgensen
O G
OG
Aas
M
M
D000328:Adult; D000368:Aged; D002116:Calcitonin / Q000097:blood; D002277:Carcinoma / Q000556:secondary* / Q000601:surgery; D005260:Female; D006503:Hepatic Veins; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D010418:Pentagastrin / Q000494:pharmacology; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy; D014680:Veins; D014682:Vena Cava, Inferior
D002116:Calcitonin; D010418:Pentagastrin