Difficulties and countermeasures in the diagnosis and treatment of medullary thyroid carcinoma
10.19538/j.cjps.issn1005-2208.2019.03.10
- Author:
Hao ZHANG
1
;
Da-lin ZHANG
1
Author Information
1. Department of Thyroid Surgery,the First Hospital of China Medical University Shenyang 110001,China
- Publication Type:Journal Article
- Keywords:
medullary thyroid carcinoma;
imaging diagnosis;
genetic detection;
surgical strategy;
multidisciplinary team
- From:
Chinese Journal of Practical Surgery
2019;39(03):225-230
- CountryChina
- Language:Chinese
-
Abstract:
Prognosis of medullary thyroid carcinoma(MTC)is worse,and occurrence of early metastasis is easy. Hereditary and sporadic MTC have different clinical characteristics and prognosis. The diagnostic value of ultrasound,CT,MRI and bone scintigraphy is special. Calcitonin(Ctn)is found to have diagnostic specificity,while carcinoembryonic antigen(CEA)is useful for evaluating disease progression. Whether hereditary or sporadic MTC,surgeons should pay attention to the subsequent genetic detection. Different surgical strategies are required for hereditary and sporadic MTC. Active surgery is necessary for patients with regional recurrence and nodal metastasis. Advanced progressive MTC could be treated by palliative surgery,external radiotherapy or systemic treatment with the tyrosine kinase inhibitor. Measurement of doubling times of serum Ctn and CEA can evaluate recurrence and metastasis after surgery.
