Medullary thyroid carcinoma presenting with an initial CEA elevation.
BACKGROUND
Carcinoembryonic antigen (CEA) is a tumour marker commonly associated with gastrointestinal malignancy. Patients presenting with an elevated CEA will therefore often undergo extensive investigations in order to elucidate an underlying gastrointestinal malignancy that may not be clinically apparent. However the GI tract is not the only source of CEA elevation.


METHODS
We present a series of patients presenting with raised CEA levels that were initially investigated for a gastrointestinal cause, but after work up were detected to have medullary thyroid cancer.


RESULTS
Four patients with raised CEA were evaluated for a gastrointestinal cause for the elevation. We discuss the non gastrointestinal causes for an elevated CEA.


CONCLUSIONS
The paper highlights that in patients presenting with an elevated CEA, in whom a gastrointestinal cause has been ruled out, a tumour of neuroendocrine origin needs to be considered as a cause for the elevated CEA.
University of Sydney Endocrine Surgical Unit, Royal North Shore Hospital, St. Leonard's 2065 NSW, Australia.
Deepak
D
Abraham
Leigh
L
Delbridge
Roderick
R
Clifton-Bligh
Phillip
P
Clifton-Bligh
Simon
S
Grodski
Bruce G
BG
Robinson
Marinella
M
Messina
Stan
S
Sidhu
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D001707:Biopsy, Needle; D002272:Carcinoembryonic Antigen / Q000097:blood*; D018276:Carcinoma, Medullary / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008991:Monitoring, Physiologic; D009367:Neoplasm Staging; D018570:Risk Assessment; D012494:Sampling Studies; D013964:Thyroid Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen