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Medullary thyroid cancer: an update for surgeons
Faris K Azar1, Stephanie L Lee, Jennifer E Rosen
1Department of Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
Abstract:
Medullary thyroid carcinoma is uncommon but accounts for approximately 4 to 5 per cent of all thyroid cancers. Although most cases are sporadic, close to one-fourth of cases result from germline mutations in the RET proto-oncogene. These mutations are clinically important because they predict the earliest age of medullary thyroid cancer diagnosis and clinical aggressiveness, which guide individualized management. This review covers the presentation, diagnosis, workup, current management, and future directions of the management of medullary thyroid carcinoma. Today's chance for cure depends on early and appropriate surgical resection. Further investigation of the cellular signaling pathways shown to be essential for the growth and spread of medullary thyroid carcinoma remains an active field with hope for providing targeted systemic therapy for patients with progressive disease.
Insights
Medullary thyroid cancer (MTC) is rare but linked to RET gene mutations. Early surgical intervention offers the best cure chance, while research explores targeted therapies for advanced cases.
Area of Science:
- Oncology
- Genetics
- Endocrinology
Background:
- Medullary thyroid carcinoma (MTC) represents 4-5% of all thyroid cancers.
- While often sporadic, 25% of MTC cases stem from germline RET proto-oncogene mutations.
- RET mutations correlate with earlier MTC diagnosis and increased clinical aggressiveness.
Purpose of the Study:
- To review the current understanding of medullary thyroid carcinoma.
- To outline diagnostic and management strategies for MTC.
- To discuss future therapeutic avenues for MTC.
Main Methods:
- This is a review article, synthesizing existing literature.
- It covers presentation, diagnosis, workup, and management of MTC.
- It also discusses ongoing research into MTC signaling pathways.
Main Results:
- Early and precise surgical resection is crucial for MTC cure.
- RET proto-oncogene mutations are key indicators for MTC prognosis.
- Targeted therapies are being investigated for progressive MTC.
Conclusions:
- Individualized management of MTC is guided by genetic factors and disease aggressiveness.
- Surgical intervention remains the cornerstone of MTC treatment.
- Further research into signaling pathways may yield novel systemic therapies for MTC.
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