To screen or not to screen for medullary thyroid cancer? This is (yet) the question. An illustrative case.

Authors

  • Rosaria Ruggeri Department of Clinical and Experimental Medicine, University of Messina
  • Luca Giovannella Department of Nuclear Medicine and Thyroid Centre, Oncology Institute of Southern Switzerland, Bellinzona
  • Francesco Trimarchi Accademia Peloritanadei Pericolanti, at the University of Messina, Messina
  • Alfredo Campennì Department of Biomedical and Dental Sciences, and Morpho-Functional Images, Unit of Nuclear Medicine, University of Messina, Messina

DOI:

https://doi.org/10.6092/1828-6550/APMB.106.2.2018.A1

Keywords:

medullary thyroid cancer, calcitonin- thyroid nodules

Abstract

Medullary thyroid cancer (MTC) is a rare disease, often displaying an aggressive behavior and a poor prognosis. Serum calcitonin represents the most sensitive marker of MTC and its routine measurement in patients with thyroid nodules allows early detection of occult MTC and appropriate surgical cure.Here we report on a 55-yr-old woman with a long-standing goiter, autonomously functioning thyroid nodules and subclinical thyrotoxicosis, who was diagnosed with MTC at an early stage by means of calcitoninscreening. This rare case highlights the importance of performing routine calcitonin measurementin thyroid nodules.

References

1. Griebeler, M.L., Gharib, H., Thompson, G.B. (2013). Medullary thyroid carcinoma. EndocrPract.19:703-711. doi: 10.4158/EP12430.

2. Trimboli, P., Giovanella, L., Crescenzi, A., Romanelli, F., Valabrega, S., Spriano, G., Cremonini, N., Guglielmi, R., Papini, E.(2014). Medullarythyroidcancerdiagnosis: an appraisal. Head Neck. 36:1216-1223.

3. Trimboli, P., Nasrollah, N., Amendola, S., Rossi, F., Ramacciato, F., Romanelli F, et al.(2012). Should we use ultrasound features associated with papillary thyroid cancer in diagnosing medullary thyroid cancer? Endocrine J. 59: 503-508.

4. Dyhdalo, K.S., Chute, D.J. (2018) Barriers to the recognition of medullary thyroid carcinoma on FNA: Implications relevant to the new American Thyroid Association guidelines. Cancer Cytopathol. doi: 10.1002/cncy.21990.

5. Elisei R. (2008) Routine serum calcitonin measurement in the evaluation of thyroid nodules. Best Pract Res ClinEndocrinolMetab.22:941-953. doi: 10.1016/j.beem.2008.09.008.

6. Haugen, B.H., Alexander, E.K., Bible, K.C., Doherty, G.M., Mandel, S.J., Nikiforov, Y.E., et al. (2016) 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. 26: 1–133. doi: 10.1089/thy.2015.0020

7. Gharib, H., Papini, E., Paschke, R., Duick, D.S., Valcavi, R., Hegedus, L., et al. (2010) 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 Invest.33:51–56.

8. Wells, S.A. Jr, Asa, S.L., Dralle, H., Elisei, R., Evans,D.B., Gagel, R.F., et al. (2015). Revised American Thyroid Association Guidelines for the Management of Medullary Thyroid Carcinoma: The American Thyroid Association Guidelines Task Force on Medullary Thyroid Carcinoma. Thyroid. 25: 567–610. doi: 10.1089/thy.2014.0335.

9. Pacini, F., Fontanelli, M., Fugazzola, L., Elisei, R., Romei, C., Di Coscio, G., Miccoli, P., Pinchera, A. (1994) Routine measurement of serum calcitonin in nodular thyroid diseases allows the preoperative diagnosis of unsuspected sporadic medullary thyroid carcinoma.J ClinEndocrinolMetab. 78:826-829.

Downloads

Published

2018-12-18

Issue

Vol. 106 No. 2 (2018)

Section

CLINICAL CASE SEMINAR

License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:
  • Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  • Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  • Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).