title: Medullary thyroid carcinoma without marked elevation of calcitonin: a diagnostic and surveillance dilemma.
abstract: 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.
authors.affiliation: Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Tracy S
authors.initials: TS
authors.lastname: Wang
authors.forename: Idris Tolgay
authors.initials: IT
authors.lastname: Ocal
authors.forename: Julie Ann
authors.initials: JA
authors.lastname: Sosa
authors.forename: Heather
authors.initials: H
authors.lastname: Cox
authors.forename: Sanziana
authors.initials: S
authors.lastname: Roman
mesh_terms: 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
chemical_list: D014408:Biomarkers, Tumor; D002116:Calcitonin