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.
|Numero di pagine||5|
|Rivista||IL GIORNALE DI CHIRURGIA|
|Stato di pubblicazione||Published - 2007|
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