Document Detail

Preoperative diagnosis of medullary thyroid carcinoma: fine needle aspiration cytology as compared with serum calcitonin measurement.
MedLine Citation:
PMID:  15999359     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVES: Preoperative diagnosis of sporadic medullary thyroid carcinoma (MTC) has mainly relied on fine needle aspiration cytology (FNAC). The present study aimed to compare the sensitivity of this technique with serum calcitonin (CT) measurement and to assess the therapeutic implications of an inadequate preoperative diagnosis. METHODS: We reviewed the clinical records of 91 MTC patients treated and/or followed at our institution between January 1990 and December 2003. RESULTS: After revision of clinical records, 77 individuals were considered eligible for the study. FNAC was performed in 67 patients (87%) with a sensitivity of 63%; serum CT was measured in 56 patients (73%) with a sensitivity of 98%. Both FNAC and serum CT were assessed in 51 patients (66%). FNAC detected only 74.5% of MTCs suspected by elevated serum CT. Among patients with a cytological diagnosis of MTC, total thyroidectomy (TT) was performed in 95% of patients. Among patients without a cytological diagnosis of MTC, TT was performed in 83% of patients in whom serum CT was evaluated prior to surgery whereas it was performed in only 46% of patients in whom CT evaluation was lacking. CONCLUSIONS: Despite the higher sensitivity of serum CT measurement, as compared with FNAC to diagnose MTC (98% vs. 63%), only 9% of patients might have escaped to surgery based on FNAC results. However, indication for surgery based on suspicious FNAC may not alert the surgeon for the need of a TT and exploration of nodes at least in the central compartment.
Maria João M Bugalho; Jorge Rosa Santos; Luís Sobrinho
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of surgical oncology     Volume:  91     ISSN:  0022-4790     ISO Abbreviation:  J Surg Oncol     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-11     Completed Date:  2005-07-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0222643     Medline TA:  J Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  56-60     Citation Subset:  IM    
Serviço de Endocrinologia, Instituto Português de Oncologia Francisco Gentil, Centro Regional de Oncologia de Lisboa, Portugal.
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MeSH Terms
Aged, 80 and over
Biopsy, Fine-Needle
Calcitonin / blood*
Carcinoma, Medullary / diagnosis*,  surgery
Middle Aged
Sensitivity and Specificity
Thyroid Gland / pathology*
Thyroid Neoplasms / diagnosis*,  surgery
Thyroid Nodule / pathology
Tumor Markers, Biological / blood*
Reg. No./Substance:
0/Tumor Markers, Biological; 9007-12-9/Calcitonin

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