Preoperative Evaluation of the Patient with Medullary Thyroid Cancer

Abstract Background: Technitium 99m sestamibi is a very useful method for preoperative localization in hyperparathyroidism. It have some limitations including false positivity due to thyroid pathology. We present a patient with positive Technitium 99m sestamibi uptake by a medullary thyroid cancer Case Presentation: A 67-year-old female referred to the endocrine clinic for evaluation of medullary thyroid cancer diagnosed by fine needle aspiration of left side thyroid nodule. TSH level was normal with high normal serum calcium and high PTH levels. No family history of medullary thyroid cancer, hyperparathyroidism or pheochromocytoma. Her plasma metanephrines were normal. Preoperative evaluation included a parathyroid scan with oral I-123 and Intravenous Technitium 99m sestamibi. I-123 scan showed a cold nodule in the left thyroid lobe and the subtraction images demonstrated persistent uptake of Technitium 99M sestamibi which was reported by the radiologist as a parathyroid adenoma. Repeated serum calcium was normal and intraoperative evaluation of parathyroid glands demonstrated no abnormal enlargement confirming that parathyroid scan was falsely positive secondary to medullary thyroid cancer. Conclusion: This case highlights the importance of careful interpretation of nuclear parathyroid scan results. False positive results have been reported with both benign and malignant thyroid disease including medullary thyroid cancer.

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Abstract #1101 The Value of Calcitonin Calcium Stimulation Test Levels as Predictors of Medullary Thyroid Cancer.

Endocrine Practice ◽

10.1016/s1530-891x(20)47466-x ◽

2018 ◽

Vol 24 ◽

pp. 273-274

Author(s):

Corin Badiu ◽

Mara Baet ◽

Ruxandra Dobrescu ◽

Andra Caragheorgheopol ◽

Corneci Cristina

Keyword(s):

Thyroid Cancer ◽

Medullary Thyroid Cancer ◽

Stimulation Test ◽

Medullary Thyroid ◽

Calcium Stimulation

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Intraoperative and postoperative care of unsuspected pheochromocytoma in medullary thyroid cancer

Otolaryngology ◽

10.1016/s0194-5998(94)70538-0 ◽

1994 ◽

Vol 111 (5) ◽

pp. 665-668

Author(s):

S YEE ◽

S STERN

Keyword(s):

Thyroid Cancer ◽

Postoperative Care ◽

Medullary Thyroid Cancer ◽

Medullary Thyroid

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Immunoscintigraphy in Medullary Thyroid Cancer Using an 123I- or 111ln-Labelled Monoclonal Anti-CEA Antibody Fragment

Nuklearmedizin ◽

10.1055/s-0038-1624348 ◽

1986 ◽

Vol 25 (06) ◽

pp. 227-231 ◽

Cited By ~ 6

Author(s):

Chr. Eilles ◽

W. Spiegel ◽

W. Becker ◽

W. Börner ◽

Chr. Reiners

Keyword(s):

Bone Marrow ◽

Thyroid Cancer ◽

Potassium Iodide ◽

Medullary Thyroid Cancer ◽

Elevated Serum ◽

Antibody Fragment ◽

Special Importance ◽

Medullary Thyroid ◽

Medullary Cancer ◽

Serum Cea

The monoclonal anti-CEA F(ab’)2 fragment MAb BW 431/31, labelled with 123I or111 In, was used for immunoscintigraphy (IS) in 9 patients with medullary cancer of the thyroid (CCC). The results of 11 studies lead to the following conclusions: 1) When using radioiodine as a label for MAb in IS, potassium iodide is absolutely necessary to block the thyroid which is of special importance in patients with thyroid cancer; 2) Preinjection of “cold” MAb reduces the relatively high unspecific uptake (especially in bone marrow) of MAb BW 431/31, which is of special importance for the antibody labelled with 111 In; 3) IS with MAb BW 413/31 in patients with CCC and elevated serum CEA is positive only in cases with large secondaries; and 4) In patients with CCC and several manifestations of secondaries, only a single (large) metastasis may be apparent.

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