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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.

AuthorPatientTNMPreopera tive CT (pg/ml)Preopera tive CEA (ng/ml)Postoperative CT (pg/ml)Postoperative CEA (ng/ml)Outcome
Sobol et al (1989) []30 1/NANANANA6 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 rangeUndete-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 1pT3 L1V1 R1N1b5.3Positive 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 7T1 N0M02.91.3NANAAlive, no tumor detectable
T4 N0M12.1Alive with pulmonary metastases, reoperation because of local tumor infiltration
T2 NxM02.8Alive, recurrence after 10 years indicated by CEA increase; after reoperation, disease free
T2 N1M02.63.1Alive, reoperation because of local tumor infiltration
T3 N1M0NANAAlive 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 N1M111NADead due to disease, locally invasive tumor, and pulmonary metastases; 3 reoperations because of local tumor infiltration, during follow-up CT became slightly elevated
T3 N1M11.51.7Dead because of pulmonary failure (metastatic MTC)
Brutsaert et al (2015) []42 1T2N0Mx23.1Positive immuno-stainingNAUS: no lymph nodes or nodules; TC: unremarkable; MRI: liver hemangioma
Zhou et al (2017) []19 19/NANAIncrease in valueNAAfter 6 years:2 cases of local recurrence;1 case of lymph nodes metastases;1 case of lymph nodes metastasis and local recurrence

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923