Angiography-proven liver metastases explain low efficacy of lymph node dissections in medullary thyroid cancer patients.
OBJECTIVE
To report the role of liver angiography in the staging of medullary thyroid cancer (MTC) patients.


METHODS
Sixty MTC patients with persistent or recurrent hypercalcitonemia (n=49), a characteristic general symptom (diarrhea, n=4) or a normal basal calcitonin level without general symptoms (n=7) were investigated by dynamic liver CT, MRI and angiography between 06/1998 and 06/2002.


RESULTS
Dual-phase CT and MRI investigations identified hepatic metastases with relatively low frequency (8/58 on MRI, and 7/60 on CT). Angiography indicated liver involvement in 54/60 cases. The hepatic metastases were typically multiple, hypervascular, small foci (only 13 foci measured >/=10 mm). With one exception significant disease progression was not observed over 5 years of follow-up.


CONCLUSIONS
Liver angiography is a powerful tool to reveal hepatic metastases in MTC patients. Frequent, inoperable liver metastases in hypercalcitoninemic MTC patients demonstrate that secondary lymph node dissection is an inefficient technique for restoration of a normal calcitonin level.
Szavcsur
P
P
Department of Diagnostic Imaging, National Institute of Oncology, Budapest, Hungary.
Godény
M
M
Bajzik
G
G
Lengyel
E
E
Repa
I
I
Trón
L
L
Boér
A
A
Vincze
B
B
Póti
Z
Z
Szabolcs
I
I
Esik
O
O
D000792:Angiography; D014408:Biomarkers, Tumor / Q000097:blood; D020295:Brain Stem Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery*; D002116:Calcitonin / Q000097:blood; D002584:Cervix Uteri / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000473:pathology* / Q000601:surgery*; D008113:Liver Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery*; D008175:Lung Neoplasms / Q000097:blood / Q000556:secondary / Q000601:surgery; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D008482:Mediastinum / Q000473:pathology / Q000601:surgery; D018213:Neoplasms, Bone Tissue / Q000097:blood / Q000556:secondary / Q000601:surgery; D013964:Thyroid Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D002116:Calcitonin