Medullary thyroid carcinoma without marked elevation of calcitonin: a diagnostic and surveillance dilemma.
Calcitonin is a sensitive tumor marker for medullary thyroid cancer (MTC) and is useful in preoperative diagnosis and postoperative surveillance for recurrent disease. Calcitonin-negative MTC is a rare occurrence. We present the case of a 68-year-old man with a 6.5 cm sporadic MTC with a 5-cm metastasis in the neck, but only minimally elevated serum calcitonin levels. He underwent total thyroidectomy, resection of internal jugular vein, and limited ipsilateral lymph node dissection. He remains disease-free 12 months after surgery. We review the literature on calcitonin-negative MTC and discuss methods of postoperative surveillance in this subset of patients.
Wang
Tracy S
TS
Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Ocal
Idris Tolgay
IT
Sosa
Julie Ann
JA
Cox
Heather
H
Roman
Sanziana
S
D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D002116:Calcitonin / Q000097:blood*; D018276:Carcinoma, Medullary / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D037981:Neck Dissection; D011183:Postoperative Complications / Q000517:prevention & control; D055502:Secondary Prevention; D013964:Thyroid Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D013965:Thyroidectomy
D014408:Biomarkers, Tumor; D002116:Calcitonin