|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.
SOURCE: Weill Cornell Medical College