title: Angiography-proven liver metastases explain low efficacy of lymph node dissections in medullary thyroid cancer patients.
abstract: 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.
authors.affiliation: Department of Diagnostic Imaging, National Institute of Oncology, Budapest, Hungary.
authors.forename: P
authors.initials: P
authors.lastname: Szavcsur
authors.forename: M
authors.initials: M
authors.lastname: Godény
authors.forename: G
authors.initials: G
authors.lastname: Bajzik
authors.forename: E
authors.initials: E
authors.lastname: Lengyel
authors.forename: I
authors.initials: I
authors.lastname: Repa
authors.forename: L
authors.initials: L
authors.lastname: Trón
authors.forename: A
authors.initials: A
authors.lastname: Boér
authors.forename: B
authors.initials: B
authors.lastname: Vincze
authors.forename: Z
authors.initials: Z
authors.lastname: Póti
authors.forename: I
authors.initials: I
authors.lastname: Szabolcs
authors.forename: O
authors.initials: O
authors.lastname: Esik
mesh_terms: 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
chemical_list: D014408:Biomarkers, Tumor; D002116:Calcitonin