[Detection of residual lesions and metastases of medullary thyroid cancer].

Persistent hypercalcitoninemia represents a frequent situation particularly in case of inadequate surgery of medullary throid carcinoma (MTC). This event conducts to a surgical re-exploration after excluding the presence of distant metastases. After adequate initial surgical treatment the localisation of the residual or recurrent tumor tissue is often difficult with conventional imaging techniques. Immunoscintigraphy and selective venous sampling for calcitonin measurements have a good diagnostic sensitivity for cervical or mediastinal localisations and also for distant metastases. However complete remissions are not the rule after cervical and/or mediastinal reintervention which are proposed to patients who are free of distant metastases. This underlines the necessity of early diagnosis of MTC and adequate first neck operation.