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The paper presents many years’ international experience in treating medullary thyroid cancer (TC). Two hundred and forty-two patients with different stages of the disease were followed up. The morphological and genetic features of this tumor are given. The results of used treatment options for medullary cancer, such as surgical, radiation, multimodality, and drug therapies, are analyzed. Surgery is a leading treatment option for this disease. The volume of surgery on a primary tumor focus depends on both the shape of a (sporadic or hereditary) tumor and its sizes. Removal of pre- and paratracheal fat is indicated for any volume of surgery for TC due to the high risk of its metastases to lymph nodes at this site. For radiotherapy there are three main indications: 1) the dubious, macroscopically and microscopically evaluated efficiency of an operation; 2) inoperable cancer; 3) distant bone metastases for palliative and symptomatic care. The now chemicals available at an oncologist’s disposal exert no significant effect on increased survival in a patient with medullary TC.

Background: Medullary thyroid cancer (MTC) is an infrequent form of thyroid cancer. We aimed to examine how gender and histological characteristics influence the rate of recurrence/persistent disease, distant metastases and survival and also to define specific characteristics of MTC microcarcinomas. Methods: The medical records of 85 patients with MTC were reviewed. The following characteristics were recorded: year of diagnosis, age at diagnosis, sex, tumor size, number of tumor foci, lymph node metastases, thyroid capsule and vascular invasion, infiltration of thyroid parenchyma and extrathyroid extension, and distant metastases. Results: During follow-up (mean 78.8 months), persistent disease occurred in 40 patients, local recurrences in 5 and distant metastases in 32 patients. Local and distant disease appeared more frequently in patients with larger tumors ( p < 0.005) and lymph node metastases ( p < 0.01). In addition, patients with invasive tumors had local and distant disease more frequently. The percentage of males who had persistent disease and/or local recurrence was significantly higher than the percentage of males who did not ( p < 0.05). Similar results were observed for distant disease ( p < 0.01). Independent predictors of recurrence and persistent disease was the presence of lymph node metastases at diagnosis (risk ratio 11.66) and of distant metastases were the presence of lymph node metastases at diagnosis (risk ratio 17.42) and the presence of vascular invasion (risk ratio 2.41). Fifteen patients died due to MTC during follow-up (17.6 %). Patients who died were more frequently males, and had thyroid capsule invasion, extrathyroidal extension, vascular invasion and metastatic disease. Conclusions: Male sex, tumor size and invasive characteristics of the tumor are negative predictive factors for evolution of MTC. [ABSTRACT FROM AUTHOR]

Objective: Medullary thyroid cancer (MTC) is a rare and particularly aggressive type of thyroid cancer of neuroendocrine origin. It occurs in hereditary and sporadic forms and its aggressiveness is related to the clinical presentation and the type of RET mutation. Methods: In this article, we present the criteria, as reviewed in contemporary literature, regarding lymph node dissection and radical neck dissection in patients with either sporadic or hereditary MTC. Results: Early diagnosis and treatment remains the key to a 100% cure rate. Conclusions: Routine central lymph node dissection is the minimum procedure recommended for all sporadic and hereditary MTCs. Routine lateral lymph node dissection on either side is necessary when lymph node metastases are found in the central neck compartment. Copyright © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]