Medullary thyroid carcinoma
Medullary thyroid carcinoma originates from parafollicular, also called C-cells, of the thyroid gland. In four clinical forms:
- sporadic (70-80% medullary ca, most aggressive)
- familial (AD inherited)
- MEN 2A and MEN 2B syndromes (together with pheochromocytoma, neurofibromas, parathyroid adenomas, ...)
Clinical picture + diagnostics
- Similar to differentiated thyroid cancer,
- secretes calcitonin ( marker),
- is more aggressive than differentiated carcinoma, at the time of diagnosis Molecular mechanisms of metastasis in more than 50% of cases,
- in medullary thyroid carcinoma in connection with MEN 2A and MEN 2B syndromes, vanillic acid is measured,
- 50% of medullary ca produces CEA (carcinoembryonic antigen).
Therapy
Total thyroidectomy, external radiation (C cells do not accumulate iodine), chemotherapy.
Forecast
Despite the aggressiveness, the prognosis is favorable - 75% of patients survive for 15 years.
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