Horm Metab Res 2020; 52(04): 216-219
DOI: 10.1055/a-1130-1992
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Usefulness of Serum Calcitonin in Patients with Thyroid Nodules ≤ 1 cm Without an Indication for Fine-Needle Aspiration

Pedro Weslley Rosario
1  Santa Casa de Belo Horizonte, Minas Gerais, Brazil
,
Gabriela Franco Mourão
1  Santa Casa de Belo Horizonte, Minas Gerais, Brazil
,
Maria Regina Calsolari
1  Santa Casa de Belo Horizonte, Minas Gerais, Brazil
› Author Affiliations
Funding: This work was supported by the National Council for Scientific and Technological Development (CNPq).
Further Information

Publication History

received 30 January 2020

accepted 27 February 2020

Publication Date:
13 March 2020 (online)

Abstract

Fine-needle aspiration (FNA) is not necessary in adults with nodules ≤ 1 cm without apparent extrathyroidal extension (ETE) or lymph node (LN) involvement on ultrasonography (US). In the absence of FNA and serum calcitonin (Ctn) measurement, medullary thyroid microcarcinomas (microMTC) are not diagnosed. The aim of this prospective study was to evaluate Ctn levels in adults with a low clinical risk of MTC and nodules ≤ 1 cm without ETE or LN involvement on US. A total of 506 consecutively seen adults who had nodules with two or more suspicious features were included. Patients with elevated basal Ctn underwent a calcium stimulation test and FNA. Basal Ctn was normal in 490 patients (96.8%). In the 16 patients with elevated basal Ctn, FNA revealed MTC in only one patient and MTC was not suspected in the 15 patients with elevated basal Ctn. Three patients with stimulated Ctn<100 pg/ml and benign cytology were not submitted to surgery. MTC was excluded by histology in three patients with stimulated Ctn<100 pg/ml and indeterminate or suspicious cytology and in eight patients with stimulated Ctn>100 pg/ml. One patient with stimulated Ctn>100 pg/ml had MTC. Ctn was undetectable 6 months after surgery in two patients with MTC. Although uncommon, even subjects without a suspicious history and with nodules ≤ 1 cm without ETE or LN involvement on US, but with suspicious findings, can have microMTC. The measurement of Ctn permits the diagnosis of these cases.