Calcitonin measurements for early detection of medullary thyroid carcinoma or its premalignant conditions in Hashimoto's thyroiditis.
The measurement of basal serum calcitonin (CT) in patients with evidence of Hashimoto's thyroiditis (HT) has been proposed in a recent study demonstrating an increased prevalence of elevated basal and stimulated CT. The aim of this study was to evaluate the frequency and relevance of elevated CT levels in HT. The basal sera CT were measured in 568 consecutive HT patients using a chemiluminescent immuno-assay. Whenever the serum CT was > 10 pg/ml, a pentagastrin (PG) stimulation test was performed. Two patients with abnormal/pathological PG tests were identified. Total thyroidectomy and lymph node dissection revealed for the first patient medullary thyroid carcinoma (MTC) and for the second patient C cell hyperplasia (CCH), together with papillary thyroid carcinoma. Our data showed a low prevalence of MTC and its premalignant condition CCH in HT patients; nevertheless, the patient with MTC presented lymph node metastasis. The fact that both cases presented without evidence of nodular thyroid disease highlights the persistent diagnostic dilemma of CT screening programs.
Schuetz
Matthias
M
Department of Nuclear Medicine, Medical University of Vienna, Austria.
Beheshti
Mohsen
M
Oezer
Semun
S
Novotny
Clemens
C
Paul
Matthias
M
Hofmann
Andrea
A
Bieglmayer
Christian
C
Niederle
Bruno
B
Kletter
Kurt
K
Dudczak
Robert
R
Karanikas
Georgios
G
Pirich
Christian
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002116:Calcitonin / Q000097:blood*; D018276:Carcinoma, Medullary / Q000097:blood* / Q000235:genetics; D004273:DNA, Neoplasm / Q000097:blood / Q000235:genetics; D005260:Female; D050031:Hashimoto Disease / Q000097:blood* / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000097:blood* / Q000235:genetics; D051096:Proto-Oncogene Proteins c-ret / Q000235:genetics; D013964:Thyroid Neoplasms / Q000097:blood* / Q000235:genetics
D004273:DNA, Neoplasm; D002116:Calcitonin; D051096:Proto-Oncogene Proteins c-ret; C099282:RET protein, human