Reference Range of Serum Calcitonin in Pediatric Population

Castagna, Maria Grazia; Fugazzola, Laura; Maino, Fabio; Covelli, Danila; Memmo, Silvia; Sestini, Fausta; Fioravanti, Carla; Fusarini, Chiara Ferraris; Scapellato, Carlo; Macchini, Francesco; Cevenini, Gabriele; Pacini, Furio

doi:10.1210/jc.2014-4508

Cited by 40 publications

(18 citation statements)

References 12 publications

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“…As long as basal calcitonin serum levels remain within normal limits, MTC has not yet developed. When these levels cross the upper normal limit (usually less than 10 pg/ml for children aged 2 years or more), malignant transformation to node‐negative MTC may have occurred. This time point may represent the last opportunity to perform prophylactic thyroidectomy without a need for central lymph node dissection.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome of prophylactic thyroidectomy in children carrying RET germline mutations

Machens

Elwerr

Lorenz

et al. 2018

British Journal of Surgery

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Background: A comprehensive assessment has not been undertaken of long-term outcomes in children carrying germline RET mutations and undergoing prophylactic thyroidectomy with the aim of preventing medullary thyroid cancer (MTC).Methods: A retrospective outcome study (1994-2017) of prophylactic thyroidectomy in children, with and without central node dissection, was performed at a tertiary surgical centre. Conclusion:Early prophylactic thyroidectomy is a viable surgical concept in experienced hands, sparing older children the postoperative morbidity associated with delayed neck surgery.

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Section: Discussionmentioning

confidence: 99%

Long-term outcome of prophylactic thyroidectomy in children carrying RET germline mutations

Machens

Elwerr

Lorenz

et al. 2018

British Journal of Surgery

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“…When these levels begin exceeding the upper normal limit of the calcitonin assay, usually <10 pg/mL for children aged 2 years and older (Castagna et al 2015), the point of malignant transformation is coming closer. In the presence of basal calcitonin serum levels ≤30 pg/mL, node metastases have not been reported (Rohmer et al 2011).…”

Section: Biochemical Window Of Opportunity: Pre-emptive Thyroidectomymentioning

confidence: 99%

Advances in risk-oriented surgery for multiple endocrine neoplasia type 2

Machens¹,

Dralle²

2018

Endocrine-Related Cancer

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Genetic association studies hinge on definite clinical case definitions of the disease of interest. This is why more penetrant mutations were overrepresented in early multiple endocrine neoplasia type 2 (MEN2) studies, whereas less penetrant mutations went underrepresented. Enrichment of genetic association studies with advanced disease may produce a flawed understanding of disease evolution, precipitating far-reaching surgical strategies like bilateral total adrenalectomy and 4-gland parathyroidectomy in MEN2. The insight into the natural course of the disease gleaned over the past 25 years caused a paradigm shift in MEN2: from the removal of target organs at the expense of greater operative morbidity to close biochemical surveillance and targeted resection of adrenal tumors and hyperplastic parathyroid glands. The lead time provided by early identification of asymptomatic MEN2 carriers under biochemical surveillance delimits a 'window of opportunity', within which (i) pre-emptive total thyroidectomy alone is adequate, circumventing morbidity attendant to central node dissection; (ii) subtotal 'tissue-sparing' adrenalectomy is sufficient, trading the risk of steroid dependency for the risk of a second pheochromocytoma in the adrenal remnant and (iii) parathyroidectomy is limited to enlarged glands, trading the risk of postoperative hypoparathyroidism for the risk of leaving behind hyperactive parathyroid glands. Future research should delineate further the mutation-specific, age-dependent penetrance of pheochromocytoma and primary hyperparathyroidism to refine the risk-oriented approach to MEN2. The sweeping changes in the management of MEN2 since the new millenium hold the hope that death and major morbidity from this uncommon disease can be eliminated in our lifetime.

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“…Mutationen in den Exons 10 und 11 findet man bei Patienten mit MEN 2A, am häufigsten sind dabei Mutationen im Codon 634. Dagegen werden Mutationen, die mit einer FMTC einhergehen, in den Exons 13-15 gefunden [5]. Zwischen dem Genotyp und dem Zeitpunkt des Auftretens und der Aggressivität des MTC besteht eine Korrelation; am höchsten ist sie bei der RET-918-Mutation, hoch bei der RET-634-und moderat bei allen anderen RET-Mutationen (▶ Tab.…”

Section: Therapie Und Follow-upunclassified

“…Es hat eine hohe Sensitivität und Spezifität in der Diagnostik und der Verlaufskontrolle zur Erfassung von Rezidiven sowie zur Definition der Heilung bei Patienten mit MTC [14]. Bei der Kalzitonin-Bestimmung sind sowohl geschlechtsabhängige als auch altersabhängige Referenzwerte zu beachten [5].…”

Section: Biochemische Diagnostikunclassified