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Clinical challenges with calcitonin-negative medullary thyroid carcinoma

  • Review – Clinical Oncology
  • Published:
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Abstract

Purpose

Medullary thyroid carcinoma (MTC) is a relatively uncommon malignant tumor of the parafollicular C cells of the thyroid, which distinguishing feature is the production of calcitonin (CT). CT is a well-recognized tool in the diagnosis and the postsurgical follow-up of patients with MTC with a high sensitivity and specificity, and represents a powerful prognostic indicator. Usually, there is a direct correlation between tumor size and basal CT levels. However, few cases of CT-negative MTCs have been reported in literature and criteria for diagnosis and follow-up are still controversial.

Methods

We performed a brief review on CT-negative MTC and reported our experience on this rare condition, focusing on the clinical characteristics at presentation, the histological and immunostaining features, and the management.

Results

Fifteen cases of large, palpable, CT-negative MTCs have been reported in the literature so far; moreover, we reported four cases followed at our center.

Conclusions

Although CT-negative MTC is rare, normal/low serum levels of CT and CEA cannot completely exclude the possibility of the diagnosis, when suspected. It is well accepted that early diagnosis is crucial, but there is still no consensus on the optimal postoperative surveillance strategy. The ultrasound evaluation of the cervical region, together with abdominal computerized tomography scan, chest X-ray, and fluorine18-fluorodeoxyglucose (18F-FDG) PET/computed tomography (FDG-PET/CT), would be recommended in the follow-up of such cases.

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Authors and Affiliations

  1. Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Torino, Città della Salute e della Scienza, Turin, Italy

    Maria Teresa Samà, Ruth Rossetto Giaccherino, Nadia Bonelli & Ezio Ghigo

  2. Oncological Endocrinology Unit, Department of Medical Sciences, University of Torino, Città della Salute e della Scienza, Turin, Italy

    Marco Gallo, Francesco Felicetti, Alessandro Piovesan & Emanuela Arvat

  3. Pathology Unit, Department of Medical Sciences, University of Torino, Città della Salute e della Scienza, Turin, Italy

    Francesca Maletta

  4. Surgery Department, Citta’ della Salute e della Scienza, Turin, Italy

    Nicola Palestini

Authors
  1. Maria Teresa Samà
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  2. Ruth Rossetto Giaccherino
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  3. Marco Gallo
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  4. Francesco Felicetti
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  5. Francesca Maletta
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  6. Nadia Bonelli
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  8. Nicola Palestini
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  9. Ezio Ghigo
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  10. Emanuela Arvat
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Correspondence to Maria Teresa Samà.

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Samà, M.T., Rossetto Giaccherino, R., Gallo, M. et al. Clinical challenges with calcitonin-negative medullary thyroid carcinoma. J Cancer Res Clin Oncol 142, 2023–2029 (2016). https://doi.org/10.1007/s00432-016-2169-5

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  • DOI: https://doi.org/10.1007/s00432-016-2169-5

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