11 September 2022: Articles
A Rare Case of Negative Serum Calcitonin in Metastatic Medullary Thyroid Carcinoma: Diagnosis, Treatment, and Follow-Up Strategy
Challenging differential diagnosis, Diagnostic / therapeutic accidents, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)
Lorena Licata A , Cristina A. Di Fidio B , Marco Vacante F , Francesco Basile D , Antonio Biondi F , Pierina Richiusa A , Alessandra Gurrera D , Roberto Ciuni A*DOI: 10.12659/AJCR.935207
Am J Case Rep 2022; 23:e935207
Table 2. CT-negative patients’ outcome in relation to preoperative and postoperative tumor marker concentrations.
| Author | Patient | TNM | Preopera tive CT (pg/ml) | Preopera tive CEA (ng/ml) | Postoperative CT (pg/ml) | Postoperative CEA (ng/ml) | Outcome |
|---|---|---|---|---|---|---|---|
| Sobol et al (1989) []30 | 1 | / | NA | NA | NA | NA | 6 months: subcutaneous masses scalp/chest wall;11 months: regrowth scar of scalp resection;14 months: markers (chromogranin A);15 months: right supraclavicular lymphadenopathy.Liver and bone metastases. The patient died |
| Redding et al (2000) []32 | 1 | / | Normal range | Undete-ctable after stimulation. Immunochemical stains: 75% | Undete-ctable after stimulation. Immunochemical stains: 6% | 30 months post-op TCs negative for residual or recurrent MTC | |
| Sand et al (2006) []34 | 1 | pT3 L1V1 R1N1b | 5.3 | Positive staining | / | Central lung emboli in the right pulmonary artery. Lung and intracerebral metastases. The patient died 6 weeks after diagnosis | |
| Frank-Raue et al (2013) []5 | 7 | T1 N0M0 | 2.9 | 1.3 | NA | NA | Alive, no tumor detectable |
| T4 N0M1 | 2.1 | Alive with pulmonary metastases, reoperation because of local tumor infiltration | |||||
| T2 NxM0 | 2.8 | Alive, recurrence after 10 years indicated by CEA increase; after reoperation, disease free | |||||
| T2 N1M0 | 2.6 | 3.1 | Alive, reoperation because of local tumor infiltration | ||||
| T3 N1M0 | NA | NA | Alive with lymph node metastases in the neck, bone and brain; after first operation, CT and CEA were normal despite multiple lymph node metastases; during follow-up, CT became slightly elevated | ||||
| T1 N1M1 | 11 | NA | Dead due to disease, locally invasive tumor, and pulmonary metastases; 3 reoperations because of local tumor infiltration, during follow-up CT became slightly elevated | ||||
| T3 N1M1 | 1.5 | 1.7 | Dead because of pulmonary failure (metastatic MTC) | ||||
| Brutsaert et al (2015) []42 | 1 | T2N0Mx | 2 | 3.1 | Positive immuno-staining | NA | US: no lymph nodes or nodules; TC: unremarkable; MRI: liver hemangioma |
| Zhou et al (2017) []19 | 19 | / | NA | NA | Increase in value | NA | After 6 years:2 cases of local recurrence;1 case of lymph nodes metastases;1 case of lymph nodes metastasis and local recurrence |