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Correspondence
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Volume 353:2817-2818 December 29, 2005 Number 26
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Prophylactic Thyroidectomy in Multiple Endocrine Neoplasia Type 2A

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by Skinner, M. A.
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To the Editor: In their report on the effects of early prophylactic thyroidectomy in patients with multiple endocrine neoplasia type 2A (MEN-2A) (Sept. 15 issue),1 Skinner et al. identified a group of patients with postoperative calcitonin levels that increased in response to calcium–pentagastrin stimulation but remained within the normal range. The finding was regarded as presumptive evidence of persistent or recurrent medullary thyroid carcinoma. An alternative possibility that has not been ruled out is that there was production of calcitonin by extrathyroidal cells, particularly cells in the parathyroid glands or lung. Immunohistochemical detection of calcitonin in hyperplastic parathyroid tissue has . . . [Full Text of this Article]



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