Abstract
Routine calcitonin measurement in patients with nodular thyroid disease is rather controversial. The aim of this study was to evaluate the contribution of serum calcitonin measurement in the diagnostic evaluation of thyroid nodules with insufficient, indeterminate, or suspicious cytology. Out of 1668 patients who underwent thyroidectomy with the diagnosis of nodular thyroid disease and were screened, 873 patients with insufficient, indeterminate, or suspicious fine-needle aspiration biopsy results were included in the study. From the total number of patients in this study, 10 (1.1%) were diagnosed as medullary thyroid cancer (MTC) using histopathology. The calcitonin level was detected to be above the assay-specific cutoff in 23 (2.6%) patients ranging between 6.5 and 4450 pg/mL. While hypercalcitoninemia was detected in all 10 MTC patients, a false positive elevation of serum calcitonin was detected in 13 patients (1.5%). Of the MTC group, seven patients had cytology results that were suspicious for malignancy (Bethesda V), one patient’s cytology showed atypia of undetermined significance (Bethesda III), and two patient’s cytology results were suspicious for follicular neoplasm (Bethesda IV). Among the cases with non-diagnostic cytology (Bethesda I), none of the patients were diagnosed with MTC. In conclusion, routine serum calcitonin measurement can be performed in selected cases rather than in all nodular thyroid patients. While it is reasonable to perform routine calcitonin measurement in patients with Bethesda IV and Bethesda V, this measurement was not useful in Bethesda I patients. In Bethesda III patients, patient-based decisions can be made according to their calcitonin measurement.
Highlights
Medullary thyroid cancer (MTC) originates from thyroid C cells and accounts for 1–2% of thyroid cancers [1]
According to the pathology results after thyroidectomy, the distribution of patients was as follows; 380 (43.6%) had nodular hyperplasia, 433 (49.6%) had papillary thyroid cancer (PTC), 33 (3.8%) had follicular thyroid cancer (FTC), 10 (1.1%) had MTC 9 (1%) had follicular patterned well differentiated carcinoma, 7 (0.8%) had encapsulated follicular-patterned thyroid tumors, and 1 (0.1%) had poorly differentiated thyroid cancer (Figure 2)
The calcitonin level was detected to be above the assay-specific cutoff value in 23 (2.6%) patients ranging between 6.5 and 4450 pg/mL
Summary
Medullary thyroid cancer (MTC) originates from thyroid C cells and accounts for 1–2% of thyroid cancers [1]. It is a rare type of cancer, and the prognosis is usually poor because most patients are diagnosed at an advanced stage or after thyroidectomy [2]. Patients with MTC usually have metastases at the time of diagnosis, and it is too late to perform curative surgery [3]. Diagnosis and successful radical surgery is very. Submitted: 11 March 2021/Accepted: 14 May 2021
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
