Box 5.39Medullary cell carcinoma of the thyroid gland

Image ch5fb39.jpg

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  • This is a multicentric neoplasm of the C cells of the thyroid gland.
  • The earliest abnormality is hyperplasia of the C cells followed by progression to nodular hyperplasia and then carcinoma.
  • Lymph node metastases are common as size of tumor increases above 1 cm diameter.
  • Treatment is total thyroidectomy with regional lymph node dissection where appropriate.
  • Tumor monitoring is by measurements of serum calcitonin (usually following stimulation by the peptide pentagastrin). Other tumor markers such as CGRP have also been used.
  • Members of families with MEN carrying loss of function mutations in the ret gene may undergo prophylactic thyroidectomy when the serum calcitonin rises above the normal range.

From: Chapter 5, The parathyroid glands and vitamin D

Cover of Endocrinology
Endocrinology: An Integrated Approach.
Nussey S, Whitehead S.
Copyright © 2001, BIOS Scientific Publishers Limited.

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