Trattamento chirurgico del carcinoma midollare della tiroide. Esperienza personale

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Introduction: Medullary Thyroid Carcinoma (MTC) is a raremalignancy of the parafollicular C cells of the thyroid gland. Aim of ourstudy is reporting retrospective analysis of our experience about the surgical treatment of MTC, especially pointing on limphadenectomy.Patients and methods: from January 2000 to March 2006, wereperformed 546 thyroidectomy, 6 of them for MTC (1.09%): 5 sporadic and 1 familiar. All the patients were operated with standard technique (total thyroidectomy) and submitted to endocrinologic and instrumental follow-up.Results: in our experience, we do not registered early or late complications as bleeding, laryngeal nerves lesions and parathyroid lesionsor intra-postoperative deaths.Discussion: MTC occurs sporadically or as part of the multiple endocrine neoplasia type 2 (MEN 2 A/B) syndromes in patients who have inherited a mutation in the RET proto-oncogene. The diagnosis ismade by fine needle aspiration biopsy (FNAB) and by measuring calcitonin levels in the blood. Primary treatment consists of surgical resection including a total thyroidectomy, central neck nodal dissection andfunctional lateral neck nodal dissections. Most patients with a palpableprimary tumour have nodal disease at the time of operation, and nodalinvolvement is often bilateral.Conclusions: adequate resection of the primary tumour and cervical lymph nodes is important to optimize outcome and minimize the risk of recurrent disease. Following primary surgical resection, more than50% of the patients will have recurrent disease with persistent elevationof calcitonin levels. Currently, there is no adequate systemic therapy forrecurrent disease. Surgical reoperation or conservative observation arethe best available options.
Lingua originaleItalian
pagine (da-a)385-389
Numero di pagine5
Stato di pubblicazionePublished - 2007

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