Serum calcitonin should be measured in patients
with thyroid nodules
(March 2004)
The background of the study.
Medullary carcinomas constitute less than 5 percent of all thyroid
carcinomas, but they are unique in that they secrete calcitonin.
This study was done to determine the value of routine measurement
of serum calcitonin in patients with thyroid nodules.
How the study was done.
Serum calcitonin was measured in 10,864 patients with thyroid nodules
seen in a single center between 1991 and 1998. Thyroid surgery was
advised in patients with high serum calcitonin values and those
in whom fine-needle aspiration biopsy was suspicious for carcinoma.
The results of the study.
Among the 10,864 patients, 47 (0.4 percent) had a high serum calcitonin
concentration. Two patients had kidney failure, which raises the
values, and one refused further testing. The biopsy diagnosis in
the remaining 44 patients was medullary carcinoma in 20, other thyroid
carcinoma in 9, and a benign thyroid nodule in 11; the biopsy was
inadequate in 4. These 44 patients underwent thyroidectomy; all
but one proved to have medullary carcinoma.
The conclusions of the study.
Serum calcitonin should be measured as part of the evaluation of
patients with thyroid nodules.
The original article.
Elisei R, Bottici V, Luchetti F, Di Coscio G, Romei C, Grasso L,
Miccoli P, Iacconi P, Basolo F, Pinchera A, Pacini F. 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.
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