Saturday, March 3, 2012

Medullary Thyroid Cancer Follow Up

Dr. Kurt Frederick, talking with patient Leigh Rhodes
Blood calcitonin monitoring is the most sensitive test to identify persistent recurrent tumor in patients with MTC.  Patients can have loco-regional or distant metastasis as their primary site of recurrence. Ultrasound of the neck by an experienced ultrasonographer is the most sensitive method for identifying residual disease.

  • If the plasma calcitonin is not elevated, patients should continue to undergo basal and provocative testing annually for 5 years. 
  • Calcitonin levels in the normal range after total thyroidectomy suggest persistent disease. Calcitonin levels greater than 1000 pg/ mL indicate distant metastasis. 
  • Chemotherapy plays a limited role in advanced surgically unamenable MTC in clinical trials.
  •  Radioiodine may play a role for destroying and residual normal thyroid tissue, and for patients with mixed tumors of follicular and parafollicular cell origin. Its role, however, is still controversial. 

No comments:

Post a Comment