Abstract
Aim. To report the role of liver angiography in the staging of medullary thyroid cancer (MTC) patients. Material and methods. Sixty MTC patients with persistent or recurrent hypercalcitonemia ( n=49), a characteristic general symptom (diarrhea, n=4) or a normal basal calcitonin level without general symptoms ( n=7) were investigated by dynamic liver CT, MRI and angiography between 06/1998 and 06/2002. Results. Dual-phase CT and MRI investigations identified hepatic metastases with relatively low frequency (8/58 on MRI, and 7/60 on CT). Angiography indicated liver involvement in 54/60 cases. The hepatic metastases were typically multiple, hypervascular, small foci (only 13 foci measured ≥10 mm). With one exception significant disease progression was not observed over 5 years of follow-up. Conclusions. Liver angiography is a powerful tool to reveal hepatic metastases in MTC patients. Frequent, inoperable liver metastases in hypercalcitoninemic MTC patients demonstrate that secondary lymph node dissection is an inefficient technique for restoration of a normal calcitonin level.
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