Serum calcitonin is a highly specific biomarker for medullary thyroid carcinoma (MTC) — p...
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | BMA-CALCITONIN-MTC-MEN2-SURVEILLANCE |
|---|---|
| Type | Actionability |
| Status | reviewed 2026-05-18 | actionability review required |
| Diseases | DIS-MTC |
| Sources | SRC-ATA-THYROID-2015 SRC-ENDOCRINE-SOCIETY-MEN-2023 SRC-NCCN-THYROID-2025 |
Actionability Facts
| Biomarker | BIO-CALCITONIN-MTC |
|---|---|
| Variant | Calcitonin — MTC surveillance in MEN2 carriers (RET codon-stratified) |
| Disease | DIS-MTC |
| ESCAT tier | IIIA |
| Recommended combinations | MEN2 carrier: annual basal calcitonin from age determined by RET codon risk stratification; prophylactic thyroidectomy timing per ATA Thyroid 2015 + Endocrine Society MEN 2023, Post-thyroidectomy MTC: serial basal calcitonin + CEA; doubling time <6 mo prompts restaging |
| Contraindicated monotherapy | PPI use causes mild calcitonin elevation — withhold ≥1 week before draw or interpret with PPI status known |
| Evidence summary | Serum calcitonin is a highly specific biomarker for medullary thyroid carcinoma (MTC) — produced by parafollicular C-cells. In MEN2 RET germline carriers, calcitonin trends inform timing of prophylactic thyroidectomy (RET codon-stratified per ATA Thyroid 2015 + Endocrine Society MEN 2023): - MEN2B (M918T): prophylactic thyroidectomy <1 year, before calcitonin rise becomes detectable - MEN2A high-risk codons (634, 883): thyroidectomy by age 5 - MEN2A moderate-risk codons (609, 611, 618, 620, 630, 631): may delay until calcitonin becomes detectable on stimulation testing Basal + stimulated (pentagastrin / calcium-stimulated where available) calcitonin tracks residual disease post-thyroidectomy. CEA is a complementary marker. Doubling time of calcitonin post-resection is a strong prognostic indicator (<6 mo = aggressive). ESCAT IIIA — calcitonin directs prophylactic surgery timing and post-operative monitoring. |
Notes
STUB pending two-Co-Lead signoff. RET codon-specific stratification is the key engine input; a future IND-MEN2-CARRIER-PROPHYLACTIC-THYROIDECTOMY Indication entity (or equivalent procedure trigger) is appropriate. CEA parallel monitoring covered separately under BIO-CEA. Render layer must always present calcitonin alongside RET codon (when known) and thyroidectomy status.
Used By
No reverse references found in the YAML corpus.