Early Diagnosis of Medullary Carcinoma of the Thyroid Gland by Means of Calcitonin Assay

Publisher Website
Google Scholar
Abstract
Medullary thyroid carcinoma was predicted correctly by means of radioimmunoassay of serum and urine calcitonin in 11 members of one family. An increased concentration of calcitonin in serum and urine either basally or in response to calcium infusion was the only indication of disease. After total thyroidectomy, serum and urinary calcitonin fell to low or undetectable levels in 10 of the 11 patients. Carcinoma was present bilaterally in all cases, none exceeding 1.4 cm in diameter, and was without evidence of metastases in five. Tumor tissue contained calcitonin concentrations ranging from 650 to 16,000 times those in normal human thyroid tissue. Parathyroid hyperplasia was present in nine cases; increased levels of parathyroid hormone were present in the serum of six, but all were normocalcemic. Previously unsuspected pheochromocytomas were found in five patients. These results suggest an important role for measurements of calcitonin as a means for screening high-risk persons for medullary carcinoma.