Brauckhoff, Katrin1; Søfteland, Eirk2; Aas, Turid1
1 Department of Endocrine Surgery, Haukeland University Hospital, Bergen, Norway
2 Department of Laboratary Medicine, Haukeland University Hospital, Bergen, Norway
Background: Preoperative serum Calcitonin (Ctn) measurement has been recommended for patients referred for thyroidectomy, but it is controversial in patients without suspicious history of medullary thyroid carcinoma (MTC) and without indication for surgery. This study evaluates Ctn screening of all patients with nodular thyroid disease referred to our hospital.
Methods: This was a retrospective study of 1450 patients with nodular thyroid disease and carried out measurement of Ctn before from January 2015 to December 2016. All patients were examined clinically and with ultrasound of the neck.
Results: 43 (3.1%) patients showed elevated Ctn.. In 30 (2%) patients with mean Ctn 3.9 (1.7-30.7 (min-max)) pmol/l we controlled the Ctn within 3 months. In the control group, all patients showed normal Ctn and surgery was not indicated. 3 patients were operated with hemithyroidectomy and had normalized Ctn postoperative. Histology stated colloid nodules without MTC or C-cell-hyperplasia (CCH). 10 (0.7%) patients were operated due to pathological Ctn or pathological stimulated Ctn. In two patients CCH with Ctn 4.6 pmol/l, respectively 5,7 pmol/l and in seven (0.5%) cases MTC was confirmed with a mean Ctn of 190 (9-898) pmol/l and RET-mutation were found in two patients. One operated patient with negative histology persistent with elevated Ctn.
Conclusion: The prevalence of MTC, diagnosed by serum Ctn measurement in a 24th month period among 1450 unselected patients with thyroid nodules was 0.5%. Primary surgery could be performed adequate, but definitive cure remains to be established based on longer follow-up.