Send the specimen to the laboratory as soon as possible
Testing performed at Waikato Hospital
Other fluids -
Tumour marker for medullary thyroid carcinoma (MTC).
Elevated calcitonin can occur in patients without medullary thyroid tumours.
An unpublished European review of 1200 subjects shows that basal calcitonin elevation to can occur in:
| Chronic renal failure | < 100 ng/L |
| Hyperparathyroidism | < 25 ng/L |
| Paget's disease | < 25 ng/L |
| Other tumours (e.g. lung, pancreas) | < 250 ng/L |
Is medullary thyroid carcinoma sporadic or familial ?
The presence of RET proto-oncogene germ line mutations that predispose to this tumour can be detected in peripheral blood by the LabPlus Molecular Genetics Department (contact via Lablink ). Peripheral blood DNA should be analysed in the patient with MTC. If the family history is negative and the patient presenting with apparently sporadic MTC does NOT have an identifiable mutation in peripheral blood DNA, then there is little or no likelihood (< 1:400) that it is familial and first degree family members do not need to be screened themselves. Confidence is further increased if one of the known mutations is identified in frozen tumour tissue (somatic) but not in peripheral blood (germ line).
Calcitonin response to pentagastrin:
A peak calcitonin level >100 ng/L is a positive result, but does not distinguish between MTC and C-cell hyperplasia.
A peak level <80 makes the likelihood of MTC remote.
Emails to chemicalpathologist@adhb.govt.nz will receive priority attention from the on-call chemical pathologist.
If the query concerns a specific patient please include the NHI number in your email.
If email is not a suitable option, please contact the on-call chemical pathologist via Lablink (Auckland City Hospital ext. 22000 or 09-3078995).
Individual chemical pathologists may be contacted but will not be available at all times.
After-hours : contact Lablink (Auckland City Hospital ext. 22000 or 09-3078995) or hospital operator for on duty staff after hours.
Dr Samarina Musaad (Clinical Lead) : SamarinaM@adhb.govt.nz ext. 22402
Dr Cam Kyle: CampbellK@adhb.govt.nz ext 22052
Dr Weldon Chiu: WeldonC@adhb.govt.nz ext. 23427
Dr Campbell Heron: CHeron@adhb.govt.nz ext. 23427
Dr Sakunthala Jayasinghe: Sakunthala@adhb.govt.nz ext. 23427
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Calcitonin - Plain/SST/Other fluids - separate and freeze as soon as possible Stable: Room temperature 2 hours Refrigerated 19 hours Minimum volume 0.5 mL |
Transport to LabPlus as a frozen aliquot.