Medullary thyroid cancer

Kebebew, Electron; Clark, Orlo H.

doi:10.1007/s11864-000-0052-7

Cited by 65 publications

(41 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…MTC originates in the parafollicular C cells of the thyroid and accounts for 3-10% of all thyroid cancers [2][3][4]. MTC occurs in the sporadic form in 70-80% or hereditary in 20-30% of patients [5].…”

Section: Introductionmentioning

confidence: 99%

The value of 18F-DOPA PET-CT in patients with medullary thyroid carcinoma: comparison with 18F-FDG PET-CT

et al. 2009

View full text Add to dashboard Cite

The purpose of this prospective study was to compare the value of DOPA PET-CT with FDG PET-CT in the detection of malignant lesions in patients with medullary thyroid carcinoma (MTC). Twenty-six consecutive patients (10 men, 16 women, mean age 59 +/- 14 years) with elevated calcitonin levels were evaluated in this prospective study. DOPA and FDG PET-CT modalities were performed within a maximum of 4 weeks (median 7 days) in all patients. The data were evaluated on a patient- and lesion-based analysis. The final diagnosis of positive PET lesions was based on histopathological findings and/or imaging follow-up studies (i.e., DOPA and/or FDG PET-CT) for at least 6 months (range 6-24 months). In 21 (21/26) patients at least one malignant lesion was detected by DOPA PET, while only 15 (15/26) patients showed abnormal FDG uptake. DOPA PET provided important additional information in the follow-up assessment in seven (27%) patients which changed the therapeutic management. The patient-based analysis of our data demonstrated a sensitivity of 81% for DOPA PET versus 58% for FDG PET, respectively. In four (4/26) postoperative patients DOPA and FDG PET-CT studies were negative in spite of elevated serum calcitonin and CEA levels as well as abnormal pentagastrin tests. Overall 59 pathological lesions with abnormal tracer uptake were seen on DOPA and/or FDG PET studies. In the final diagnosis 53 lesions proved to be malignant. DOPA PET correctly detected 94% (50/53) of malignant lesions, whereas only 62% (33/53) of malignant lesions were detected with FDG PET. DOPA PET-CT showed superior results to FDG PET-CT in the preoperative and follow-up assessment of MTC patients. Therefore, we recommend DOPA PET-CT as a one-stop diagnostic procedure to provide both functional and morphological data in order to select those patients who may benefit from (re-)operation with curative intent as well as guiding further surgical procedures.

show abstract

Section: Introductionmentioning

confidence: 99%

The value of 18F-DOPA PET-CT in patients with medullary thyroid carcinoma: comparison with 18F-FDG PET-CT

et al. 2009

View full text Add to dashboard Cite

show abstract

“…According to the American Association of Clinical Endocrinology and the Society of Surgical Oncology guidelines, a modified radical neck dissection of the ipsilateral and contralateral compartment is indicated only when there is evidence of suspicious or metastatic nodes at preoperative imaging or cytology (AACE. Clinical practice guidelines for the diagnosis and management of thyroid nodules 1996, Mazzaferri 1999, Kebebew & Clark 2000).…”

Section: Introductionmentioning

confidence: 99%

Clinically unpredictable prognostic factors in the outcome of medullary thyroid cancer

Miccoli¹,

Minuto²,

Ugolini³

et al. 2007

Endocrine Related Cancer

View full text Add to dashboard Cite

Total thyroidectomy and central neck dissection are the procedures of choice in patients affected with medullary thyroid cancer. It is known that a medullary thyroid cancer with node metastases can be rarely cured, and therefore the utility of a modified radical neck dissection in the absence of suspicious node metastases still needs further evidence. The study aims to verify whether other epidemiological and pathological parameters could affect the prognosis of medullary thyroid cancer patients. We prospectively studied 70 medullary thyroid cancer patients consecutively operated on (from 2000 to 2004) at the same institution and analysed by the same pathologists. All patients underwent total thyroidectomy and central lymphadenectomy. In 27 cases, the ipsilateral (nZ19) or bilateral (nZ8) modified radical neck dissection was performed in the presence of suspicious lateral neck node metastases. After surgical treatment, basal and stimulated serum calcitonins (Cts) were measured in all patients. Follow-up ranged between 1 and 4 years. Patients were considered 'cured' when stimulated Ct was undetectable. Age, sex, tumour size, tumour capsule, multicentricity, nodes in the central neck and mean number of positive nodes were analysed in 'cured' and 'not-cured' patients. The presence of node metastases in the central compartment was significantly correlated with the outcome of the patients, being present in 9 and 72% of cured and not-cured patients respectively (P!0.000001). Tumour size was also significantly correlated with the outcome of the disease (P!0.00006). The presence of the tumour capsule correlated with better prognosis (PZ0.0005) and absence of node metastases (PZ0.0080). By multivariate analysis, the presence of node metastasis remained the most significant variable affecting the outcome of the disease (PZ0.000014). Our results show that the outcome of encapsulated cancer is significantly better regardless of tumour size and node metastases. Although the early diagnosis and the extensive surgical treatment may favour the good outcome of medullary thyroid cancer, they do not always guarantee the definitive cure of the disease, being the capsular infiltration an independent bad prognostic factor.

show abstract

“…Patients with clinically evident Medullary thyroid cancer should have a total extra capsular thyroidectomy with bilateral central neck dissection and therapeutic modified (functional) radical neck dissection when the primary tumor is greater than 1 cm and when the central neck nodes are positive [30]. Medullary thyroid cancer is a tumor of the thyroid C cells that occurs in sporadic and hereditary clinical settings.…”

Section: Medullary Thyroid Cancermentioning

confidence: 99%