Onkologie. 2011:5(6):336-339
Medullarythyroidcarcinoma - diagnostic a therapeutic alternative
- Klinika nukleární medicíny endokrinologie 2. LF UK FN Motol, Praha
Medullarythyroidcarcinoma (MTC) accountsfor 8–10 % of allthyroidcancers. MTC ismainlysporadic, but anhereditarypattern (multipleendocrineneoplasia
type 2 (MEN 2)) ispresent in 25–30 % of cases, as anautosomal-dominant traitdue to germlinemutations of the
RET proto-oncogene. Theprimarytreatment of bothhereditary and sporadicforms of MTC istotalthyroidectomy and removal of allneoplastictissuepresent.
Aftersurgery, measurements of serumcalcitonin as a tumourmarkerand carcinoembryonic antigen are markers
in thepostsurgicalfollow-up of patientswith MTC as theyreflectthe presence of persistentorrecurrentdisease. Completeremissionisdemonstrated
by undetectable and stimulatedserumcalcitoninmeasurement. In patiens withelevatedbasalcalcitoninorafterstimulation
are performedimagingmethods (ultrasound of theneck, CT, scintigraphy, PET/CT).Metastasesoutsidetheneckmayoccur in the liver,
lungs, bones and, lessfrequently, brain. Surgeryisthemaintreatmentforlocal and distantmetastaseswheneverfeasible. In generalisation
of dinase are performedtheraphywith131I-MIBG in somecases. Systemicchemotherapyhas very limited efficacyorduration. Familialcasesmustbeidentified
by searchingfor RET proto-oncogenemutations in the proband and in familymembers.
Keywords: medullarythyrodcancer, RET proto-oncogene, MEN 2
Published: December 1, 2011 Show citation
References
- Schlumberger M, Pacini F, et al. Medullarythyroidcarcinoma. In: Thyroidtumors. NucleonParis 1999: 267-307.
- MarshDJ, Learoyd DL, Robinson BG. Medullary thyroid carcinoma: recentadvances and management update. Thyroid 1995; 5(5): 407-24.
Go to original source... 
Go to PubMed... - Ríos A, Rodríguez JM, Febrero B, Acosta JM, Torregrosa N, Balsalobre M, Parrilla P. Histological and immunohistochemical profile of sporadic and familial medullary thyroid carcinoma. Endocrinol Nutr. 2011 Oct 31. Go to original source... Go to PubMed...
- Jackson TA, Choong KW, Eng JA, McAneny D, Subramaniam RM, Knapp PE. F-18 FDG PET/CT Imaging of Endogenous Cushing Syndrome. Clin Nucl Med 2011; 36(12): 231-232. Go to original source... Go to PubMed...
- Panigrahi B, Roman SA, Sosa JA. Medullary thyroid cancer: are practicepatterns in the United States discordant from American Thyroid Association guidelines? Ann Surg Oncol 2010; 17(6): 1490-1498. Go to original source... Go to PubMed...
- Lew JI, Snyder RA, Sanchez YM, Solorzano CC. Fine need leaspiration of thethyroid: correlation with final histopathology in a surgicalseries of 797 patients. J Am Coll Surg 2011; 213(1): 188-194. Go to original source... Go to PubMed...
- Copp DH. Calcitonin: discovery, development and clinical application. Clin Invest Med 1994; 17(3): 268-277.
- Bendlová B, Dvoráková S, Václavíková E, Vlcek P. Multipleendocrineneoplasia type 2 syndrome. Klin Onkol 2009; 22(Suppl): S28-31. Go to PubMed...
- Atiq MT, Joarder AH, Alam MM, Hossain MA, Biswas SS. Analysis of post operative complications following total thyroidectomy. Mymensingh Med J 2011; 20(2): 238-244. Go to PubMed...
- Postema EJ, McEwan AJ. Radio iodinated meta iodobenzyl guanid inetreatment of neuroendocrinetumors in adults. Cancer Biother Radiopharm 2009; 24(5): 519-525. Go to original source... Go to PubMed...
- Rufini V, Castaldi P, Treglia G, Perotti G, Gross MD, Al-Nahhas A, Rubello D. Nuclear medicine procedures in thediagnosis and therapy of medullary thyroid carcinoma. Biomed Pharmacother 2008; 62(3): 139-146. Go to original source... Go to PubMed...