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Should Calcitonin Be Measured in Every Thyroid Nodule?

  • Mine Adaş
  • Gökhan Adaş
Chapter

Abstract

There are controversial suggestions in the literature about the routine measurement of calcitonin (Ct) in thyroid nodules. Barriers in front of measuring routine serum calcitonin are cost-effectiveness and the possibility of having elevated serum Ct in the absence of medullary thyroid carcinoma (MTC). Here we report a sporadic MTC patient with negative fine needle aspiration biopsy (FNAB) result whose diagnosis was made by preoperative calcitonin measurement. As we perform routine Ct measurement before surgery, the surgeon becomes aware of the MTC earlier, and this gives the opportunity of making an appropriate surgical procedure which is crucial for patients’ outcome.

References

  1. 1.
    Ahmed SR, Ball DW. Incidentally discovered medullary thyroid cancer: diagnostic strategies and treatment. J Clin Endocrinol Metab. 2011;96:1237–45.CrossRefGoogle Scholar
  2. 2.
    Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26:1–133.CrossRefGoogle Scholar
  3. 3.
    Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedus L, et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: executive summary of recommendations. J Endocrinol Investig. 2010;33(5 Suppl):51–6.Google Scholar
  4. 4.
    Elisei R, Romei C. Calcitonin estimation in patients with nodular goiter and its significance for early detection of MTC: European comments to the guidelines of the American Thyroid Association. Thyroid Res. 2013;6(Suppl 1):S2.CrossRefGoogle Scholar
  5. 5.
    Pacini F, Fontanelli M, Fugazzola L, Elisei R, Romei C, Di Coscio G, et al. Routine measurement of serum calcitonin in nodular thyroid diseases allows the preoperative diagnosis of unsuspected sporadic medullary thyroid carcinoma. J Clin Endocrinol Metab. 1994;78:826–9.PubMedGoogle Scholar
  6. 6.
    Rieu M, Lame MC, Richard A, Lissak B, Sambort B, Vuong-Ngoc P, et al. Prevalence of sporadic medullary thyroid carcinoma: the importance of routine measurement of serum calcitonin in the diagnostic evaluation of thyroid nodules. Clin Endocrinol. 1995;42:453–60.CrossRefGoogle Scholar
  7. 7.
    Niccoli P, Wion-Barbot N, Caron P, Henry JF, de Micco C, Saint Andre JP, et al. Interest of routine measurement of serum calcitonin: study in a large series of thyroidectomized patients. The French Medullary Study Group. J Clin Endocrinol Metab. 1997;82:338–41.CrossRefGoogle Scholar
  8. 8.
    Vierhapper H, Raber W, Bieglmayer C, Kaserer K, Weinhäusl A, Niederle B. Routine measurement of plasma calcitonin in nodular thyroid diseases. J Clin Endocrinol Metab. 1997;82:1589–93.CrossRefGoogle Scholar
  9. 9.
    Kaserer K, Scheuba C, Neuhold N, Weinhäusel A, Vierhapper H, Haas OA. C-cell hyperplasia and medullary thyroid carcinoma in patients routinely screened for serum calcitonin. Am J Surg Pathol. 1998;22:722–8.CrossRefGoogle Scholar
  10. 10.
    Ozgen AG, Hamulu F, Bayraktar F, Yilmaz C, Tüzün M, Yetkin E, et al. Evaluation of routine basal serum calcitonin measurement forearly diagnosis of medullary thyroid carcinoma in seven hundred seventy-three patients with nodular goiter. Thyroid. 1999;9:579–82.CrossRefGoogle Scholar
  11. 11.
    Hahm JR, Lee MS, Min YK, Lee MK, Kim KW, Nam SJ, et al. Routine measurement of serum calcitonin is useful for early detection of medullary thyroid carcinoma in patients with nodular thyroid diseases. Thyroid. 2001;11:73–80.CrossRefGoogle Scholar
  12. 12.
    Verga U, Ferrero S, Vicentini L, Brambilla T, Cirello V, Muzza M, et al. Histopathological and molecular studies in patients with goiter and hypercalcitoninemia: reactive or neoplastic C-cell hyperplasia? Endocr Relat Cancer. 2007;14:393–403.CrossRefGoogle Scholar
  13. 13.
    Elisei R, Bottici V, Luchetti F, Di Coscio G, Romei C, Grasso L, et al. Impact of routine measurement of serum calcitonin on the diagnosis and outcome of medullary thyroid cancer: experience in 10,864 patients with nodular thyroid disorders. J Clin Endocrinol Metab. 2004;89:163–8.CrossRefGoogle Scholar
  14. 14.
    Cheung K, Roman SA, Wang TS, Walker HD, Sosa JA. Calcitonin measurement in the evaluation of thyroid nodules in the United States: a cost-effectiveness and decision analysis. J Clin Endocrinol Metab. 2008;93:2173–80.CrossRefGoogle Scholar
  15. 15.
    Turk Y, Makay O, Ozdemir M, Ertunc G, Demir B, Icoz G, et al. Routine calcitonin measurement in nodular thyroid disease management: is it worthwhile? Ann Surg Treat Res. 2017;92:173–8.CrossRefGoogle Scholar
  16. 16.
    Hu MI, Ying AK, Jimenez C. Update on medullary thyroid cancer. Endocrinol Metab Clin N Am. 2014;43:423–42.CrossRefGoogle Scholar
  17. 17.
    Lim SK, Guéchot J, Vaubourdolle M. Negative predictive value of procalcitonin in medullary thyroid carcinoma. Ann Biol Clin. 2016;74:213–8.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Mine Adaş
    • 1
  • Gökhan Adaş
    • 2
  1. 1.University of Health Sciences (SBÜ), Okmeydanı Training and Research HospitalIstanbulTurkey
  2. 2.University of Health Sciences (SBÜ), Haseki Training and Research HospitalIstanbulTurkey

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