Giessen H, Nebiker CA, Bruehlmeier M, Spreitzer S, Mueller B, Schuetz P. Do you want to participate in a clinical study as a healthy control? - Risk or benefit? World J Clin Cases 2017; 5(12): 437-439 [PMID: 29291203 DOI: 10.12998/wjcc.v5.i12.437]
Corresponding Author of This Article
Dr. Philipp Schuetz, MD, Professor, Department of Internal Medicine, Kantonsspital Aarau, Tellstrasse 1, Aarau 5000, Switzerland. philipp.schuetz@ksa.ch
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 16, 2017; 5(12): 437-439 Published online Dec 16, 2017. doi: 10.12998/wjcc.v5.i12.437
Do you want to participate in a clinical study as a healthy control? - Risk or benefit?
Hanna Giessen, Christian A Nebiker, Matthias Bruehlmeier, Stefan Spreitzer, Beat Mueller, Philipp Schuetz
Hanna Giessen, Beat Mueller, Philipp Schuetz, Department of Internal Medicine, Kantonsspital Aarau, Aarau 5000, Switzerland
Christian A Nebiker, Department of Surgery, Kantonsspital Aarau, Aarau 5000, Switzerland
Matthias Bruehlmeier, Department of Nuclear Medicine, Kantonsspital Aarau, Aarau 5000, Switzerland
Stefan Spreitzer, Department of Pathology, Kantonsspital Aarau, Aarau 5000, Switzerland
Author contributions: Giessen H and Schuetz P contributed to drafting the manuscript; Nebiker CA, Bruehlmeier M, Spreitzer S and Mueller B contributed to revising the manuscript critically for important intellectual content.
Informed consent statement: The patient involved in this study gave her written informed consent authorizing use.
Conflict-of-interest statement: All contributing authors have no financial and personal relationships with other people or organisations that could inappropriately influence or bias their work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Philipp Schuetz, MD, Professor, Department of Internal Medicine, Kantonsspital Aarau, Tellstrasse 1, Aarau 5000, Switzerland. philipp.schuetz@ksa.ch
Telephone: +41-62-8386812
Received: May 14, 2017 Peer-review started: May 17, 2017 First decision: July 5, 2017 Revised: November 3, 2017 Accepted: November 10, 2017 Article in press: November 10, 2017 Published online: December 16, 2017 Processing time: 206 Days and 20 Hours
Abstract
A healthy woman volunteered to participate as “healthy control” in a study. An increased level of procalcitonin (PCT) was detected and remained elevated on follow-up measurements. As calcitonin levels were elevated as well, thyroid ultrasound was performed which revealed nodes in both thyroid lobes, one of them showing metabolic activity in positron emission tomography-computed tomography scan. To exclude a malignant thyroid cancer despite the negative findings in a fine needle aspiration the patient underwent thyroidectomy and a medullary thyroid carcinoma (MTC) was detected in the right lobe. MTC is a rare endocrine tumor with a poor prognosis once having spread, therefore early detection remains a priority for the outcome. Screening parameter is serum calcitonin, in absence of infection the pro-hormone PCT can be used as a screening parameter as well with high sensitivity.
Core tip: A lady participating as healthy control in a study was found to suffer from a medullary thyroid cancer, a type of cancer in total surgical removal before the tumor has spread is the most important prognostic factor. The difficulty is the low diagnostic accuracy of ultrasound and procalcitonin-computed tomography scan, as well as the limitations of fine needle aspiration in a patient with several nodules. This case illustrates the consequences of volunteering as a “healthy control” in a clinical study. While early detection of the MCT was possible in our patient it paid off for her, but abnormal test results may also cause harm to patients if being false positive and leading to invasive procedures.
