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CASE REPORT
Year : 2013  |  Volume : 17  |  Issue : 3  |  Page : 524-528

False positive results using calcitonin as a screening method for medullary thyroid carcinoma


1 Department of Functional Neurosurgery, Institute of Psychiatry, University of Sao Paulo, USP, Brazil
2 Department of Surgery, Division of Head and Neck Surgery, Faculty of Medicine, University of Sao Paulo, USP, Brazil

Correspondence Address:
Rafael Loch Batista
Al Joaquim Eugênio de Lima 1058/102 Jardins - São Paulo/SP-01403-002, ¹Hospital das Clínicas da Universidade de São Paulo - USP
Brazil
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.111677

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The role of serum calcitonin as part of the evaluation of thyroid nodules has been widely discussed in literature. However there still is no consensus of measurement of calcitonin in the initial evaluation of a patient with thyroid nodule. Problems concerning cost-benefit, lab methods, false positive and low prevalence of medullary thyroid carcinoma (MTC) are factors that limit this approach. We have illustrated two cases where serum calcitonin was used in the evaluation of thyroid nodule and rates proved to be high. A stimulation test was performed, using calcium as secretagogue, and calcitonin hyper-stimulation was confirmed, but anatomopathologic examination did not evidence medullar neoplasia. Anatomopathologic diagnosis detected Hashimoto thyroiditis in one case and adenomatous goiter plus an occult papillary thyroid carcinoma in the other one. Recommendation for routine use of serum calcitonin in the initial diagnostic evaluation of a thyroid nodule, followed by a confirming stimulation test if basal serum calcitonin is showed to be high, is the most currently recommended approach, but questions concerning cost-benefit and possibility of diagnosis error make the validity of this recommendation discussible.


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