5 Surgeon performed ultrasound is a useful localization test for recurrent medullary thyroid carcinoma.
|Article Type:||Perspectiva general de la enfermedad/trastorno|
Enfermedades de la tiroides
Enfermedades de la tiroides (Analisis de casos)
Enfermedades de la tiroides (Cuidado y tratamiento)
Exploracion con ultrasonido (Historia)
Exploracion con ultrasonido (Analisis de casos)
Cancer (Investigacion cientifica)
Cancer (Analisis de casos)
Cancer (Cuidado y tratamiento)
|Publication:||Name: Puerto Rico Health Sciences Journal Publisher: Universidad de Puerto Rico, Recinto de Ciencias Medicas Language: Spanish Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2009 Universidad de Puerto Rico, Recinto de Ciencias Medicas ISSN: 0738-0658|
|Issue:||Date: June, 2009 Source Volume: 28 Source Issue: 2|
|Geographic:||Geographic Name: Puerto Rico|
5 Surgeon Performed Ultrasound is a Useful Localization Test for
Recurrent Medullary Thyroid Carcinoma. Rivera M, Abdul-Hadi A, Estronza
S, M6ndez W; Department of Surgery, University of Puerto Rico, Medical
Sciences Campus, San Juan, Puerto Rico.
Introduction: Localization of recurrent medullary thyroid carcinoma (MTC) in patients presenting with elevated calcitonin after initial surgery sometimes involve multiple tests. Surgeon performed ultrasound (SUS) is a simple, rapid test that may accurately localize recurrent disease. Method: Five patients with history of surgery for (MTC) and elevated calcitonin were evaluated between July, 2007 and August, 2008. Previous surgeries included Total Thyroidectomy (TT) (n=2), TT with central neck dissection (CND) (n=2) and TT with CND and ipisilateral jugular lymph node sampling (n=1). No other neck surgeries have been performed since the initial procedure. History, physical examination and SUS were performed during initial evaluation. SUS evaluated the central and lateral neck compartments. Enlarged, rounded lymph nodes with loss of central streak were considered positive (P-USLN). Neck and chest CT Scan and Fluorodeoxyglucose-Positron emission tomography (FDG-PET) were done in all patients. All patients with localized disease in neck underwent modified neck dissection according to anatomical location. Jugular chain was defined as Groups II-V Ipsilateral (IJC) or contralateral jugualar chain (CJC) were identified according to initial tumor location in thyroid. Calcitonin levels were measured after surgery. Results: PE revealed palpable lesions in two (2/5) patients. SUS revealed P-USLN in the IJC in five patients (5/5), one patient also presented P-USLN in the CJC (1/5). Neck CT Scan showed enlarged IJC LN in three patients (3/5). No patients showed enlarged LN in the CJC (0/5). None of the patients (0/5) had suspicious lesions in chest CT Scan. Three patients (3/5) presented ipsilateral cervical metastatic foci on FDG-PET. Four patients (4/5) underwent ipsilateral modified neck dissection and one patient underwent bilateral MND. Permanent pathology reported all (5/5) IJC with positive LN (3-9 positive LN) and in the only (1/1) CJC (2 positive LN). Calcitonin levels normalized in two (2/5) patients and decreased (31%-50% decrease) in three (3/5) patients. Conclusion: SUS is a useful test to localize recurrent MTC in patients with hypercalcitonemia.
|Gale Copyright:||Copyright 2009 Gale, Cengage Learning. All rights reserved.|