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Steven P. Hodak, Kenneth D. Burman, The Calcitonin Conundrum—Is It Time for Routine Measurement of Serum Calcitonin in Patients with Thyroid Nodules?, The Journal of Clinical Endocrinology & Metabolism, Volume 89, Issue 2, 1 February 2004, Pages 511–514, https://doi.org/10.1210/jc.2003-031983
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The contentious question regarding who should have calcitonin testing for the evaluation of early sporadic medullary thyroid carcinoma just got a little more confusing. Medullary thyroid carcinoma is a rare calcitonin-secreting neoplasm that occurs in both a familial and sporadic form. Seventy-five percent of medullary cancers are sporadic, whereas the remaining 25% occur as part of either the familial medullary thyroid cancer or multiple endocrine neoplasia type 2 syndromes (1). Medullary thyroid cancer represents approximately 4% of all thyroid malignancies. When medullary thyroid cancer presents with nodular disease, it is frequently metastatic, and the prognosis is usually poor. Early diagnosis and definitive treatment with total thyroidectomy, before the development of lymph node or distant metastases, offers the best hope of cure (2–4). It has been suggested that calcitonin testing, both with and without pentagastrin stimulation, may facilitate the early diagnosis of this disease and ultimately decrease morbidity and mortality (5–9).