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Medullary thyroid carcinoma in Northern Ireland, 1967-1997.

S J Dolan1, C F Russell

  • 1Department of Endocrine Surgery, Royal Victoria Hospital, Belfast, UK.

Annals of the Royal College of Surgeons of England
|June 20, 2000
PubMed
Summary

Management of medullary thyroid carcinoma (MTC) has evolved. Total thyroidectomy is now the primary choice, with genetic testing enabling early intervention for familial MTC, improving cure rates.

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Area of Science:

  • Endocrine Surgery
  • Oncology
  • Genetics

Background:

  • Review of medullary thyroid carcinoma (MTC) management in a specialist endocrine surgery unit.
  • Analysis of 38 patient cases over 30 years.

Purpose of the Study:

  • To review the experience of managing medullary thyroid carcinoma (MTC).
  • To analyze changes in MTC management over a 30-year period.

Main Methods:

  • Retrospective case record review of 38 MTC patients.
  • Analysis of sporadic versus familial MTC (multiple endocrine neoplasia types 2A, 2B, FMTC).

Main Results:

  • Sporadic MTC patients were older and presented with more advanced disease than MEN 2A patients.
  • Survival was significantly worse for sporadic MTC compared to MEN 2A.
  • Familial MTC cases showed bilateral, multifocal tumors, unlike sporadic MTC's unilateral presentation.
  • Genetic testing facilitated early identification and pre-clinical thyroidectomy in familial cases.

Conclusions:

  • Total thyroidectomy is the recommended primary procedure for all MTC patients.
  • Genetic testing allows for early, pre-clinical thyroidectomy in familial MTC, improving prospects for a permanent cure.

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