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Persistent elevation of carcinoembryonic antigen as first presentation of a medullary thyroid carcinoma
  1. Aires Martins,
  2. Alvaro Gonçalves,
  3. Teresa Almeida,
  4. Alberto Midões
  1. Cirurgia Geral, Unidade Local de Saúde do Alto Minho EPE, Viana do Castelo, Portugal
  1. Correspondence to Dr Aires Martins, aires75martins{at}


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.

  • thyroid disease
  • endocrine cancer
  • screening (oncology)
  • head and neck surgery

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  • Contributors AMa: performed initial colon surgery, patient follow-up, design of manuscript, research, manuscript revision and approval. AG and TA: analysis, revision and approval. AMi: director of general surgery department, revision and approval.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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