To the Editor.—
We report here a case of medullary carcinoma of the thyroid with upper mediastinal metastases treated with radiation therapy. The patient is a 52-year-old woman who had a right-lobe thyroidectomy in 1957 because of the tumor. In November 1972, the remainder of the thyroid gland was ablated with 88 millicuries of sodium iodide I 131. In July 1973, the patient suffered wheezing and dyspnea at rest, secondary to severe tracheal narrowing resulting from recurrent carcinoma extending into the mediastinum, as noted on the chest x-ray film; serum calcitonin level at this time was 22 ng/ml (normal, < 0.1 ng/ml). The patient refused surgery and therefore received 5,000 rads of 6-mev x-rays in 29 fractions for a period of 43 days. Her symptoms progressively diminished and she is now asymptomatic. A later chest x-ray film has not shown any considerable change save for slight radiation fibrosis. Serum calcitonin
Greenfield LD, Small RC, Byfield JE. Medullary Thyroid Carcinoma. JAMA. 1974;229(14):1864. doi:10.1001/jama.1974.03230520012007
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