RESUMO
The authors have studied 43 patients operated on for medullary thyroïd carcinoma. Plasma calcitonin was measured regularly in all patients, while carcinoembryonic antigen assay was performed in only 30 patients. Calcitonin assay was found to be useful for preoperative diagnosis of medullary carcinoma, and the level of plasma calcitonin appeared to be roughly correlated with tumor extension. After surgery, simultaneous assay of calcitonin and carcinoembryonic antigen was performed, in order to obtain more accurate information concerning the evolution and prognosis of the disease. In most cases in which no metastatic lymph nodes had been discovered at operation, the level of the two markers rapidly fell to undetectable values. It was observed that in patients with lymph node involvement, cervico-mediastinal radiation treatment did not change the slow and progressive evolution of the disease. However, a rapid increase in titre of carcinoembryonic antigen occurred simultaneously with the discovery of metastases, even when calcitonin levels did not dramatically change.
Assuntos
Calcitonina/sangue , Antígeno Carcinoembrionário/análise , Carcinoma/sangue , Neoplasias da Glândula Tireoide/sangue , Carcinoma/cirurgia , Humanos , Metástase Linfática , Prognóstico , Neoplasias da Glândula Tireoide/cirurgiaRESUMO
Medullary thyroid carcinoma (MTC) is hereditary in 20 to 25% of cases. It is inherited as an autosomal dominant trait. MTC can be considered as a sporadic form only after a clinical and biological survey of the two parents, siblings and children of the patient, using pentagastrin stimulation test. The authors have studied 36 patients from 26 families. Hereditary MTC with different clinical features, were discovered in two kindreds. The systematic investigation leads to the discovery of 7 cases in the first family, and of 3 in the second. The treatment of the disease at the first stage of its evolution has been possible when an early diagnosis had been made, such as in the second family.
