[The concept of "microsurgical" technique in medullary thyroid carcinoma]

Medullary thyroid carcinomas (MTC) metastasize early into the regional lymph nodes. Calcitonin is a highly specific and sensitive marker for these tumors, which is feasible for follow-up and for screening. Additionally, in families with hereditary MTC the responsible mutations of the RET-proto-oncogene can be identified, and prophylactic surgery can be provided. We operated on 127 patients for MTC, 114 of whom had diagnosed carcinomas; 13 operations were performed with prophylactic intention. A total of 101 patients needed microsurgical dissection of the cervical compartments. Of these, 31% could be cured, and a further 46% showed postoperatively normalized basal calcitonin concentrations. Thirteen patients who needed mediastinal dissection had persistent increased levels of pentagastrin-stimulated or basal calcitonin values. All patients who underwent prophylactic surgery could be cured.