A patient has a thyroid nodule without a family history of medullary thyroid cancer and without ultrasound features suggesting it. Which statement about calcitonin testing is most accurate?
NICE does not recommend routine calcitonin measurement for all nodules. It is appropriate when family history or ultrasound appearances raise specific concern for medullary thyroid carcinoma.
A. Do not measure calcitonin routinely unless medullary cancer is specifically suspected: NICE does not recommend routine calcitonin measurement for all nodules. It is appropriate when family history or ultrasound appearances raise specific concern for medullary thyroid carcinoma.
B. Measure calcitonin in every thyroid nodule: This is not the NICE recommendation and increases false-positive investigations.
C. Calcitonin is useful only after total thyroidectomy: It is an important diagnostic and surveillance marker when medullary carcinoma is suspected or confirmed.
D. A normal TSH excludes medullary carcinoma: Medullary carcinoma arises from C cells and is not excluded by thyroid-function tests.
E. Use thyroid peroxidase antibody instead: TPO antibodies assess autoimmune thyroid disease, not medullary carcinoma.
If the patient's sibling carried a pathogenic RET variant, genetic/endocrine evaluation and calcitonin assessment would be appropriate.
Independent Clinora educational preparation material; not official JCIE content, an accredited programme, clinical advice, or a substitute for local policy and specialist judgement.
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