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Sporadic medullary thyroid carcinoma: clinical data from a university hospital
Correia-Deur, Joya Emilie M; Toledo, Rodrigo A; Imazawa, Alice T; Lourenço Júnior, Delmar M; Ezabella, Marilza C. L; Tavares, Marcos R; Toledo, Sergio P. A.
Affiliation
  • Correia-Deur, Joya Emilie M; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Unidade de Endocrinologia Genética, Laboratórios de Investigação Médica (LIM-25). São Paulo. BR
  • Toledo, Rodrigo A; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Unidade de Endocrinologia Genética, Laboratórios de Investigação Médica (LIM-25). São Paulo. BR
  • Imazawa, Alice T; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Unidade de Endocrinologia Genética, Laboratórios de Investigação Médica (LIM-25). São Paulo. BR
  • Lourenço Júnior, Delmar M; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Unidade de Endocrinologia Genética, Laboratórios de Investigação Médica (LIM-25). São Paulo. BR
  • Ezabella, Marilza C. L; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Unidade de Endocrinologia Genética, Laboratórios de Investigação Médica (LIM-25). São Paulo. BR
  • Tavares, Marcos R; Universidade de São Paulo. Faculdade de Medicina. Departamento de Cirurgia de Cabeça e Pescoço. São Paulo. BR
  • Toledo, Sergio P. A; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Unidade de Endocrinologia Genética, Laboratórios de Investigação Médica (LIM-25). São Paulo. BR
Clinics ; Clinics;64(5): 379-386, 2009. tab
Article de En | LILACS | ID: lil-514737
Bibliothèque responsable: BR1.1
ABSTRACT

INTRODUCTION:

Medullary thyroid carcinoma may occur in a sporadic (s-medullary thyroid carcinoma, 75 percent) or in a multiple endocrine neoplasia type 2 form (MEN2, 25 percent). These clinical forms differ in many ways, as s-medullary thyroid carcinoma cases are RET-negative in the germline and are typically diagnosed later than medullary thyroid carcinoma in MEN2 patients. In this study, a set of cases with s-medullary thyroid carcinoma are documented and explored.

PURPOSE:

To document the phenotypes observed in s-medullary thyroid carcinoma cases from a university group and to attempt to improve earlier diagnosis of s-medullary thyroid carcinoma. Some procedures for diagnostics are also recommended.

METHOD:

Patients (n=26) with apparent s-medullary thyroid carcinoma were studied. Their clinical data were reviewed and peripheral blood was collected and screened for RET germline mutations.

RESULTS:

The average age at diagnosis was 43.9 years (± 10.82 SD) and did not differ between males and females. Calcitonin levels were increased in all cases. Three patients presented values that were 100-fold greater than the normal upper limit. Most (61.54 percent) had values that were 20-fold below this limit. Carcinoembryonic antigen levels were high in 70.6 percent of cases. There was no significant association between age at diagnosis, basal calcitonin levels or time of disease onset with thyroid tumor size (0.6-15 cm). Routine thyroid cytology yielded disappointing diagnostic accuracy (46.7 percent) in this set of cases. After total thyroidectomy associated with extensive cervical lymph node resection, calcitonin values remained lower than 5 pg/mL for at least 12 months in eight of the cases (30.8 percent). Immunocyto- and histochemistry for calcitonin were positive in all analyzed cases. None of the 26 cases presented germline mutations in the classical hotspots of the RET proto-oncogene.

CONCLUSION:

Our cases were identified late. The basal ...
Sujet(s)
Mots clés
Texte intégral: 1 Indice: LILACS Sujet Principal: Tumeurs de la thyroïde / Carcinome médullaire Type d'étude: Observational_studies / Risk_factors_studies Limites du sujet: Adolescent / Adult / Female / Humans / Male langue: En Texte intégral: Clinics Thème du journal: MEDICINA Année: 2009 Type: Article
Texte intégral: 1 Indice: LILACS Sujet Principal: Tumeurs de la thyroïde / Carcinome médullaire Type d'étude: Observational_studies / Risk_factors_studies Limites du sujet: Adolescent / Adult / Female / Humans / Male langue: En Texte intégral: Clinics Thème du journal: MEDICINA Année: 2009 Type: Article