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- • An elevated serum calcitonin after total thyroidectomy and a modified radical neck dissection for medullary
- carcinoma suggests persistent disease. Families of all patients with medullary carcinoma should also be
- screened. Serum calcitonin will be sampled after the intravenous injection of calcium and pentagastrin.
- • CEA (carcinoembryonic antigen) levels are useful in predicting prognosis and discovering persistent disease in
- patients with medullary thyroid carcinoma.
- • Blood tests, including serum alkaline phosphatase, are done to look for metastatic disease in the liver or bone.
- An elevated alkaline phosphatase level could suggest either liver or bone metastasis , leading to liver and bone
- scans. Selective venous catheterization for serum calcitonin is sometimes helpful for locating metastatic
- tumors.
-
- Imaging
- • Images of the thyroid can be taken after injection of a radioactive iodine tracer or of technetium 99m. Because
- thyroid cancers do not generally take up as much iodine as normal thyroid tissue , a cancer appears as a cold
- area on a scan. Only about 20 percent of cold nodules are cancer, however, and "warm" nodules are rarely
- malignant . Though used extensively in the past to classify nodules as hot or cold, thyroid scans are used less
- and less because more information is provided by FNA.
-