If this is normal, they should have a pentagastrin infusion study to see if they secrete too much calcitonin. Total thyroidectomy is indicated if they have abnormal studies. Interestingly, the calcitonin does not always go down after total thyroidectomy. If it does, the patient can be followed with pentagastrin infusion studies. It may also characteristically produce amyloid, which stains green with congo red.
Most authors recommend sub-total or total thyroidectomy.
In patients with neck mass, a neck dissection is indicated. In patients with the familial form, only abnormal parathyroid glands should be removed. A total thyroidectomy is always indicated in these familial patients. The c-cells do not take up radioactive iodine, so it is not used. This is a rare tumor with terrible prognosis.