Seventeen patients with medullary thyroid carcinoma (MTC) underwent venous catheterization (VC) for
sampling and serum calcitonin (CT) assay. The VC was performed either after an initial treatment in order to detect cervical recurrences and metastases (16 patients) or to prove abnormal CT thyroid secretion before any treatment (one patient). In 16 of the 32 tumoral localizations suspected by VC (50%), a tumoral focus was proven. For selective/peripheral CT gradient value superior to 2.50, 12 localizations of 12 (100%) were proven and for CT gradient value between 1.50 and 2.50, four localizations of 15 (26.6%) were proven. In six patients with exclusive cervical MTC secreting sites, treatment induced a total remission in two cases (12%) and improved in four cases (23%). The authors conclude that VC has a real value to localize MTC secreting sites. A total remission or an improvement can be obtained after treatment when VC detects exclusive cervical tumors.
Cancer 63:133-138, 1989.
EDULLARY THYROID CARCINOMA (MTC) represents 3% to 10% of all thyroid rnalignan~y.'-~ It may present either as sporadic or familial forms which associate other endocrine manifestation^.'.^ Local extension and metastases involve lymph nodes, bones, liver, arid lungs. Surgery remains the efficient treatment if all tumoral burden can be r e m ~v e d . ~-~-~-~ After treatment, M:TC may be followed using the serum markers: calcitonin (CT) and carcinoembryonic antigen (CEA)."-17 Abnormal CT level means persistance of residual disease arid reincreasing CT level after normalization means relapse.
Venous catheterization (VC) for sampling and determination of tumoral marker levels allows to localize or to suspect microscopic tumoral secreting masses in many sites of the body,'4-18-21 especially when morphologic investigations are negative or doubtful. The current study evaluates the diagnostic value of VC with serum CT determination in localizing MTC sites of CT production arid the therapeutic implications of this localization.
Materials and Methods
Over the last 7 years, 17 patients (1 1 male and six female patients) treated at the Institut Gustave Roussy for MTC From the