CALCITONIN LEVELS IN FNAB-WASHOUT OF THYROID NODULES (NOT SUSPICIOUS OF HAVING MEDULLARY THYROID CARCINOMA)

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: MON 471-496-Thyroid Neoplasia & Case Reports
Clinical
Monday, June 17, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board MON-477
Thomas Martin Hernandez1, Clara Garcia Garcia*1, Natividad Gonzalez Rivera1, Pilar Sanchez1, Antonio Barco2, Alberto Torres Cuadro1, Virginia Martin Manzano3 and Angel Sendon Perez1
1University Hospital, Seville, Spain, 2University Hospital, Sevilla, Spain, 3University of Seville, Sevilla, Spain
INTRODUCTION: We study calcitonin levels in the thyroid nodules through the fine needle aspiration (FNAB) process. The objective is to obtain a level close to the usual calcitonin level and to differentiate it from a medullary thyroid carcinoma (MTC), establishing a correlation between the thyroid nodules, calcitonin serum and the FNAB cytology.

MATERIALS AND METHODS: Our sample is formed by 109 patients (average age 53,7±13,4, range 18-85 years old, 79,8% women, 27,5% smokers, 18,3% with autoimmune thyroid disease). We have done a FNAB (sonographyc guided) of the thyroid nodules not suspicious of having MTC (average size 20,1± 9,3mm) to all of the patients. The same needle and syringe used in the FNAB was washed with 1ml of a 0.9% sodium chloride solution and was sent to the laboratory in order to measure the calcitonin level in the wash-out fluid. Calcitonin levels in serum (S-CT) and calcitonin levels in wash-out fluid (WO-CT) were measured with a chemiluminescence test (IMMULITE 2000).

RESULTS: In our patients, the average result of S-CT were 3,07+/-3.22 ng/l (range 2-19,4 ng/l), and 3,98+/-10,36 ng/l (range 2-97 ng/l) for WO-CT. In 2 cases, the WO-CT values were 10 times higher than the highest level found. One of the cases presented a cytology compatible with a benign thyroid disease and the other case was compatible with papillary thyroid carcinoma. Both cases were taken to surgery, where a MCT (S-CT/WO-CT: 382/32.250 ng/ml) and a  microMTC/hyperplasia cells C (CTs/CT-FNAB: 4,5/1.150 ng/ml) were found respectively. In all other cases, the WO-CT showed no significant correlation with the studied parameters (age, gender/sex, presence of autoimmune thyroiditis, tobacco, BMI), except for a weak correlation with S-CT (r: 0,17, p<0.04).

CONCLUSIONS: Calcitonin measurement in wash-out fluid from FNAB can be an additional and early warning method for a MTC diagnosis.

Nothing to Disclose: TMH, CGG, NGR, PS, AB, ATC, VMM, ASP

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm