Medullary Thyroid Carcinoma

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,