Korean J Endocr Surg.  2005 Jun;5(1):29-31. 10.16956/kjes.2005.5.1.29.

Medullary Thyroid Cancer Misunderstanding as Recurrent Rectal Cancer due to High Serum CEA Levels

• Kim JH

• KMID: 2375969
• DOI: http://doi.org/10.16956/kjes.2005.5.1.29

Abstract

The medullary carcinoma of the thyroid gland is relatively rare tumor, accounting about 1.2~10% of the all thyroid malignancies, which arises from the parafollicular C-cells in thyroid gland. Operation is the only means to cure the patients. Serial concentrations of serum CEA and calcitonin seem to play an important role in the diagnosis and clinical management and also in the therapeutic monitoring of patients with medullary thyroid cancer. In this case, patient with high serum CEA levels after the resection of rectal cancer underwent abdomen CT scan, colonofibroscopy, FDG-PET scan and chest X-ray, but this imaging methods couldn't detect recurrent evidence of rectal cancer. Neck ultrasonography was performed after 8 years from operation, and fine needle aspiration biopsy was performed for thyroid nodule. As diagnosed to suspicious medullary carcinoma, patient underwent total thyroidectomy and central compartment neck dissection. Patient diagnosed as medullary thyroid cancer without lymph node metastasis and capsular invasion pathologically. As well as this case, in patients with high serum CEA levels after definitive surgical resection of gastrointestinal cancer, if imaging study or FDG-PET scan detect no evidence of recurrence, evaluation of thyroid such as neck ultrasonography and serum calcitonin should be performed.

Keyword

CEA; Medullary thyroid cancer; Rectal cancer

MeSH Terms

Abdomen
Biopsy
Biopsy, Fine-Needle
Calcitonin
Carcinoma, Medullary
Diagnosis
Gastrointestinal Neoplasms
Humans
Lymph Nodes
Neck
Neck Dissection
Neoplasm Metastasis
Rectal Neoplasms*
Recurrence
Thorax
Thyroid Gland*
Thyroid Neoplasms*
Thyroid Nodule
Thyroidectomy
Tomography, X-Ray Computed
Ultrasonography
Calcitonin