Lack of elevated serum carcinoembryonic antigen and calcitonin in medullary thyroid carcinoma

Thyroid : Official Journal of the American Thyroid Association
Maximilian BockhornChristoph E Broelsch

Abstract

Medullary thyroid carcinoma (MTC) originates from C-cells. A wide variety of tumor markers including calcitonin (CT), carcinoembryonic antigen (CEA), and chromogranin A are produced by MTC. Surgery remains the only potentially curative therapy, and early detection of the primary remains the most important prognostic factor for a positive outcome for the patient. The following case concerns a 50-year-old woman with histologically proven MTC, who completely lacked serum elevation of both CT and CEA. We performed a total thyroidectomy with lymphadenectomy in the central compartment. Histologic sections were stained for CT, CEA, and chromogranin A. Additionally we examined the patient's blood for mutations in the RET proto-oncogene. Serum CT and CEA were below the detection level in the serum. The tumor showed weak staining for CT, but strong staining for CEA and chromogranin A. Sequencing of the RET-proto-oncogene revealed no mutations. Five years after the operation, the patient remains well and shows no signs of tumor recurrence. We hereby report of a patient with neither plasma elevation of CT nor CEA. From the clinical standpoint, it is important to determine how this subgroup of MTC should be followed because CT and CEA are o...Continue Reading

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Citations

Mar 24, 2007·International Journal of Clinical Oncology·Hiroko YamadaYasushi Yatabe
Apr 15, 2008·Endocrine Pathology·Marco Volante, Mauro Papotti
Dec 17, 2005·Thyroid : Official Journal of the American Thyroid Association·H VierhapperS Baumgartner-Parzer
Jul 25, 2008·Thyroid : Official Journal of the American Thyroid Association·José Miguel DoraAna Luiza Maia
Jul 25, 2008·Thyroid : Official Journal of the American Thyroid Association·Tracy S WangSanziana Roman
Feb 1, 2011·Thyroid : Official Journal of the American Thyroid Association·Victoriya S ChernyavskyStanley Z Trooskin
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