Serum Calcitonin May Falsely Estimate Tumor Burden in Chronic Hypercalcemia: A Case of Prostatic and Multiple Bone Metastases from Medullary Thyroid Cancer

Thyroid ◽  
2014 ◽  
Vol 24 (3) ◽  
pp. 599-603 ◽  
Author(s):  
Hee Kyung Kim ◽  
Woo Kyun Bae ◽  
Yoo Duk Choi ◽  
Hyun Jeong Shim ◽  
Jee Hee Yoon ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Bone Metastases ◽  
Medullary Thyroid Cancer ◽  
Tumor Burden ◽  
Serum Calcitonin ◽  
Medullary Thyroid ◽  
Multiple Bone Metastases

scholarly journals Surgical approach to medullary thyroid cancer

2007 ◽  
Vol 51 (5) ◽  
pp. 818-824 ◽  
Author(s):  
Catharina Ihre Lundgren ◽  
Leigh Delbridg ◽  
Diana Learoyd ◽  
Bruce Robinson
Keyword(s):  
Thyroid Cancer ◽  
Total Thyroidectomy ◽  
Medullary Thyroid Cancer ◽  
Prophylactic Surgery ◽  
Surgical Removal ◽  
Serum Calcitonin ◽  
Medullary Thyroid ◽  
Central Lymph Node Dissection ◽  
Familial Form ◽  
Men 2A

Medullary thyroid cancer (MTC) compromises 3-5% of all thyroid cancers and arises from parafollicular or calcitonin-producing C cells. It may be sporadic (75% of cases), or may occur as a manifestation of either the hereditary syndrome Multiple Endocrine Neoplasia type 2 (MEN 2A or MEN 2B) (25% of cases), or rarely as an isolated familial syndrome (FMTC). Complete surgical resection comprising in most cases total thyroidectomy with central lymph node dissection at an early stage of the disease is the only potential cure for MTC. The familial form of the disease, MEN-2A occupies a unique place in surgical history, having been the first disease where surgical removal of an affected organ was undertaken before the development of malignancy, solely on the basis of genetic testing. Total thyroidectomy prior to the development of invasive cancer completely avoids an otherwise lethal malignancy. Timing of prophylactic surgery is based on models that utilise genotype-phenotype correlations, which have now been stratified into three risk groups based on the specific codon involved. MTC should be followed with postoperative serial serum calcitonin levels to survey for persistent or recurrent disease as indicated by detectable levels. The challenge however, if calcitonin levels are increased, is to find the source of its production. The first localisation technique recommended would be ultrasound of the neck, since there is a high frequency of local recurrence and cervical node metastasis, followed by a total body CT scan and bone scintigraphy.

scholarly journals Metastatic Lymph Node Ratio for Predicting Recurrence in Medullary Thyroid Cancer

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5842
Author(s):  
Jinyoung Kim ◽  
Jun Park ◽  
Hyunju Park ◽  
Min Sun Choi ◽  
Hye Won Jang ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Medullary Thyroid Cancer ◽  
Lymph Node Ratio ◽  
Serum Calcitonin ◽  
Free Survival ◽  
Medullary Thyroid ◽  
Node Ratio ◽  
Postoperative Serum

The lymph node ratio (LNR) has been investigated as a prognostic factor in many different types of cancers, including differentiated thyroid cancer; however, reports regarding medullary thyroid cancer (MTC) are limited. Therefore, this study aims to evaluate LNR as a risk factor for structural recurrence in patients with MTC. Medical records of patients treated for MTC in a single tertiary center between 1995 and 2017 were retrospectively reviewed. LNR is defined as the number of metastatic lymph nodes or lymph node metastases (LNM) divided by the number of retrieved lymph nodes or lymph node yield (LNY). In the survival analysis, recurrence-free survival was defined as the time from the date of total thyroidectomy to recurrence or last follow-up. To identify risk factors influencing structural recurrence, univariable and multivariable Cox proportional hazard models were used. A total of 132 patients were enrolled. The mean age of study participants was 49.7 years, and 86 patients (65%) were women. Structural recurrence was identified in 39 patients at the end of the study period, and the median follow-up period was 8.7 years. In univariable analyses, gross extra thyroidal extension, N stage, postoperative serum calcitonin and carcinoembryonic antigen (CEA) levels, and LNR were significant (p < 0.05) predictors of structural recurrence. In multivariable analysis, postoperative serum calcitonin, postoperative serum CEA, and LNR were identified as a predictor of disease-free survival (p < 0.05). LNR can potentially predict structural recurrence as a quantitative evaluation tool for lymph node metastasis in patients with MTC.

scholarly journals Late-Onset Medullary Thyroid Cancer in a Patient with a Germline RET Codon C634R Mutation

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1448
Author(s):  
Agnieszka Walczyk ◽  
Kajetan Zgubieński ◽  
Grzegorz Chmielewski ◽  
Kinga Hińcza-Nowak ◽  
Artur Kowalik ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
High Risk ◽  
Germline Mutation ◽  
Medullary Thyroid Cancer ◽  
Response To Therapy ◽  
American Thyroid Association ◽  
Prophylactic Thyroidectomy ◽  
Serum Calcitonin ◽  
Medullary Thyroid

Background: Multiple endocrine neoplasia type 2A (MEN2A) is a rare, hereditary syndrome resulting from a germline mutation in the RET proto-oncogene and characterized primarily by medullary thyroid cancer (MTC), pheochromocytoma (PHEO), and hyperparathyroidism. Types of RET mutation have been associated with age at onset, clinical outcomes of MTC, and the penetrance of other components. Patients classified as ‘high-risk’ by the American Thyroid Association (ATA), based on the aggressiveness of MTC and the penetrance of other components, are recommended to undergo early prophylactic thyroidectomy at age ≤ 5 years and to be screened for PHEO at age ≥ 11 years. Patients with RET codon C634R mutations have been classified as high-risk. Case presentation: The present study describes a 71-year-old woman newly diagnosed with hereditary MTC related to a RET C634R germline mutation. Her basal serum calcitonin level was high, but there was no evidence of distant metastases. Surgery revealed bilateral MTC with two metastatic lymph nodes. Because microscopic resection was incomplete and extranodal extension was observed, the patient underwent adjuvant external beam radiotherapy. Response to therapy was excellent. Follow-up after 1.5 years showed no evidence of disease or other manifestations of MEN2A. Conclusion: Despite RET C634R carriers being classified as high-risk by the ATA, this patient did not present with either distant MTC or PHEO until her seventies. To our knowledge, only one other patient has shown a similar late identification of a RET C634R mutation, but MTC could not be diagnosed because the patient was lost to follow-up. Further research is required to develop optimal protocols that could allow patients requiring prophylactic thyroidectomy to be differentiated from those who can be monitored closely without early surgery.

External Beam and Nuclear Therapy of Medullary Thyroid Cancer

2021 ◽  
Vol 66 (1) ◽  
pp. 79-84
Author(s):  
I Pimonova ◽  
V. Krylov ◽  
P Isaev ◽  
T. Kochetova ◽  
E Borodavina
Keyword(s):  
Thyroid Cancer ◽  
Bone Metastases ◽  
Radionuclide Therapy ◽  
Medullary Thyroid Cancer ◽  
Combined Therapy ◽  
Somatostatin Analogs ◽  
Distant Metastases ◽  
Targeted Drugs ◽  
Medullary Thyroid ◽  
Peptide Receptor

The article reviews domestic and foreign literature on the use of radiation therapy in the treatment of medullary thyroid cancer. The possibilities of various radiation methods in the treatment of patients with distant metastases are shown. In addition to classical types of remote irradiation, data are presented on the possibilities of radionuclide therapy (peptide-receptor therapy with somatostatin analogs and radionuclide therapy with osteotropic drugs for bone metastases). Methods of combined therapy with the use of osteomodifying agents, targeted drugs and other methods are described, which make it possible to increase the effectiveness of treatment of patients with medullary thyroid cancer with bone metastases.

scholarly journals Comparison of 68Ga PET/CT to Other Imaging Studies in Medullary Thyroid Cancer: Superiority in Detecting Bone Metastases

2018 ◽  
Vol 103 (9) ◽  
pp. 3250-3259 ◽  
Author(s):  
Luciana Audi Castroneves ◽  
George Coura Filho ◽  
Ricardo Miguel Costa de Freitas ◽  
Raphael Salles ◽  
Raquel Ajub Moyses ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Bone Metastases ◽  
Medullary Thyroid Cancer ◽  
Imaging Studies ◽  
Medullary Thyroid ◽  
Pet Ct

scholarly journals Tumor cells may circulate in medullary thyroid cancer patients independently of serum calcitonin

2018 ◽  
Vol 25 (12) ◽  
pp. L59-L63 ◽  
Author(s):  
Sathya Neelature Sriramareddy ◽  
Etienne Hamoir ◽  
Marcela Chavez ◽  
Renaud Louis ◽  
Albert Beckers ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Patients ◽  
Tumor Cells ◽  
Medullary Thyroid Cancer ◽  
Serum Calcitonin ◽  
Medullary Thyroid
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