Persistent elevation of carcinoembryonic antigen as first presentation of a medullary thyroid carcinoma

BMJ Case Rep. 2018 Jun 11:2018:bcr2017223233. doi: 10.1136/bcr-2017-223233.

Abstract

Carcinoembryonic antigen (CEA) is still the most widely used tumour marker for gastrointestinal cancer. CEA was originally thought to be a specific marker for colorectal cancer, but it turned out to be a non-specific marker for further studies. CEA levels can be elevated in breast, lung and liver cancers, among others, including medullary thyroid cancer. The authors report a case of a 73-year-old woman who had a right hemicolectomy for an ascending colon adenocarcinoma and showed a persistent elevation in the CEA marker during follow-up. After several imaging tests, recurrence of the colon cancer was not found, but the presence of thyroid nodules had been detected. The diagnosis of a medullary thyroid carcinoma was made after the finding of a high value of calcitonin. The patient had a total thyroidectomy with resection of the central and lateral lymph nodes.

Keywords: endocrine cancer; head and neck surgery; screening (oncology); thyroid disease.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biomarkers, Tumor / blood
  • Biopsy, Fine-Needle
  • Calcitonin / blood*
  • Carcinoembryonic Antigen / blood*
  • Carcinoma, Neuroendocrine / blood
  • Carcinoma, Neuroendocrine / diagnosis*
  • Carcinoma, Neuroendocrine / pathology
  • Colonoscopy
  • Female
  • Gastroscopy
  • Humans
  • Positron Emission Tomography Computed Tomography
  • Thyroid Neoplasms / blood
  • Thyroid Neoplasms / diagnosis*
  • Thyroid Neoplasms / pathology
  • Thyroidectomy

Substances

  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • Calcitonin

Supplementary concepts

  • Thyroid cancer, medullary