To screen or not to screen for medullary thyroid cancer? This is (yet) the question. An illustrative case.
DOI :
https://doi.org/10.6092/1828-6550/APMB.106.2.2018.A1Mots-clés :
medullary thyroid cancer, calcitonin- thyroid nodulesRésumé
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.Références
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.
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