Histopathological and molecular studies in patients with goiter and hypercalcitoninemia: Reactive or neoplastic C-cell hyperplasia?

Uberta Verga, Stefano Ferrero, Leonardo Vicentini, Tatiana Brambilla, Valentina Cirello, Marina Muzza, Paolo Beck-Peccoz, Laura Fugazzola

Research output: Contribution to journalArticlepeer-review

Abstract

The cut-off values able to differentiate between reactive or neoplastic C-cell hyperplasia (CCH) or to predict sporadic medullary thyroid cancer (MTC) are still debated both for basal and stimulated calcitonin (bCT and sCT). In the present study, the prevalence and the histological patterns of CCH in 15 patients with multinodular goiter (MNG), bCT>10 pg/ml and sCT levels >50 pg/ml were studied. As controls, 16 patients with MNG and bCT levels 50 pg/ml were associated with CCH or MTC, being the total number of C-cells/60 fields significantly higher than that found in MNG with normal bCT (P=0.0008) and comparable with that detected in FMTCs. In the group with sCT>50 pg/ml, the C-cells displayed a neoplastic phenotype. Neither germline nor somatic RET mutations were found. In conclusion, sCT levels >50 pg/ml were always associated with CCH, without correlation between CT levels and the number of C-cells or the final diagnosis. The C-cells had a morphology and distribution pattern similar to those observed in FMTC. Thus, sCT levels >50 pg/ml indicate the presence of CCH with a possible preneoplastic potential, suggesting the opportunity to perform a prophylactic surgical treatment.

Original languageEnglish
Pages (from-to)393-403
Number of pages11
JournalEndocrine-Related Cancer
Volume14
Issue number2
DOIs
Publication statusPublished - Jun 2007

ASJC Scopus subject areas

  • Endocrinology
  • Oncology
  • Cancer Research
  • Endocrinology, Diabetes and Metabolism

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