HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: ERC-08-0059v1 16/1/243    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (4) Citing Articles via Google Scholar Google Scholar Articles by Scheuba, C Articles by Niederle, B Search for Related Content PubMed PubMed Citation Articles by Scheuba, C Articles by Niederle, B

Division of General Surgery, Section of Endocrine Surgery, Department of Surgery, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria¹ Department of Clinical Pathology, Medical University of Vienna, Wahringer Gürtel 18-20, A-1090 Vienna, Austria² Children's Cancer Research Institute, Kinderspitalgasse 6, A-1090 Vienna, Austria³ Radiology Department, University of Utah, Salt Lake City, Utah, UT 84132, USA⁴ Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Wahringer Gürtel 18-20, A-1090 Vienna, Austria⁵ Clinical Institute for Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Wahringer Gürtel 18-20, A-1090 Vienna, Austria

(Correspondence should be addressed to C Scheuba; Email: christian.scheuba{at}meduniwien.ac.at; B Niederle; Email: bruno.niederle{at}meduniwien.ac.at)

‘Calcitonin screening’ is not accepted as the standard of care in daily practice. The clinical and surgical consequences of ‘calcitonin screening’ in a series of patients with mildly elevated basal calcitonin and pentagastrin stimulated calcitonin levels are presented. 260 patients with elevated basal (>10 pg/ml) and stimulated calcitonin levels (>100 pg/ml) were enrolled in this prospective study. None of the patients was member of a known medullary thyroid carcinoma family. Thyroidectomy and bilateral central and lateral neck dissections were performed. Testing for the presence of germ-line mutations was performed in all patients. Histological and immunohistochemical findings were compared with basal and stimulated calcitonin levels. All patients were subsequently followed biochemically. C-cell hyperplasia (CCH) was found in 126 (49%) and medullary thyroid cancer was found in 134 (51%) patients. RET proto-oncogen mutations were documented in 22 (8%) patients (medullary thyroid cancer:18, CCH:4). In 56 (46%) of 122 patients, sporadic CCH was classified neoplastic (‘carcinoma in situ’). Of 97 (72%; 10 with hereditary medullary thyroid cancer) had pT1 (International Union against Cancer recommendations 2002) and 33 (25%) had pT2 or pT3 and 4 (3%) pT4 tumors. Of 39 (29.1%) had lymph node metastases. 106 (79.1%; 15 (38.5%) with lymph node metastases) patients were cured. Evaluation of basal and stimulated calcitonin levels enables the prediction of medullary thyroid cancer. All patients with basal calcitonin >64 pg/ml and stimulated calcitonin >560 pg/ml have medullary thyroid cancer. Medullary thyroid cancer was documented in 20% of patients with basal calcitonin >10 pg/ml but <64 pg/ml and stimulated calcitonin >100 pg/ml but <560 pg/ml.

This article has been cited by other articles:

				A. Machens, F. Hoffmann, C. Sekulla, and H. Dralle Importance of gender-specific calcitonin thresholds in screening for occult sporadic medullary thyroid cancer Endocr. Relat. Cancer, December 1, 2009; 16(4): 1291 - 1298. [Abstract] [Full Text] [PDF]

				R. Ramachandran, P. Benfield, W. S. Dhillo, S. White, R. Chapman, K. Meeran, M. Donaldson, and N. M. Martin Need for Revision of Diagnostic Limits for Medullary Thyroid Carcinoma with a New Immunochemiluminometric Calcitonin Assay Clin. Chem., December 1, 2009; 55(12): 2225 - 2226. [Full Text] [PDF]