Language
Country/Area
No result found
The hidden enemy of thyroid cancer: How to identify medullary thyroid cancer?
Medullary thyroid cancer (MTC) is a type of thyroid cancer that originates from parathyroid follicular cells (C cells). These cells are responsible for producing calcitonin, which accounts for about 3% of all thyroid cancer cases and is the third most common thyroid cancer. Medullary thyroid cancer was first described in 1959, and approximately 25% of cases have inherited genetic alterations, primarily caused by mutations in the RET oncogene.
Medullary thyroid cancer accounts for approximately 3% of all thyroid cancer cases.
Some types of medullary thyroid cancer are sporadic, referring to isolated cases not associated with other endocrine tumors, while others are familial, usually associated with multiple endocrine neoplasia type 2 (MEN2A and MEN2B). related.
Symptoms and Signs
The main clinical symptom of medullary thyroid cancer is diarrhea, occasionally accompanied by flushing. These symptoms occur particularly in the setting of liver metastases and may also be the first manifestation of the disease. The flushing of medullary thyroid cancer is indistinguishable from that caused by carcinoid syndrome, but the mucoid rash and diarrhea caused by elevated calcitonin gene products are often early signs of this cancer.
The flushing, diarrhea, and itching of medullary thyroid cancer are caused by elevated calcitonin levels.
People with medullary thyroid cancer often develop thyroid nodules and swollen lymph nodes in the neck. The cancer can spread to regional lymph nodes in the neck, lymph nodes in the chest, liver, lungs, bones, and, less often, the skin or brain.
Genetic factors
Mutations in the RET oncogene are closely associated with medullary thyroid cancer, and are responsible for almost all cases of hereditary or familial medullary thyroid cancer. This hereditary tumor is inherited in an autosomal dominant manner, meaning that each child of an affected parent has a 50% chance of inheriting the mutated gene. Early genetic analysis could allow for screening of cases and early surgical removal of the thyroid gland to address potential problems.
Diagnostic Methods
The diagnosis of medullary thyroid cancer is mainly through fine needle aspiration (FNA) to accurately identify thyroid lesions. Microscopic examination will show lymphocytic proliferation and amyloid matrix. A recent systematic review showed that basal and stimulated calcitonin testing has high sensitivity and specificity in the diagnosis of medullary thyroid cancer, but its value is still unclear.
Treatment Options
Surgery and radiotherapy are currently the main treatments for medullary thyroid cancer. The best surgical approach is total thyroidectomy and bilateral neck dissection, but for patients at high risk of local recurrence, postoperative radiotherapy is an option that must be considered.
The study showed that patients who received external beam radiotherapy had a significantly higher rate of local/regional recurrence-free than those in the control group.
In addition, clinical trials of protein kinase inhibitors have also shown their potential for application. For some patients who are not well treated, this class of drugs provides new hope.
Prognosis
The overall 5-year survival rate of medullary thyroid cancer has been reported in different literatures as 80% to 86%, while the 10-year survival rate is approximately 75%. The prognosis varies depending on the stage of the tumor, and the survival rate decreases significantly when the cancer has spread to the lymph nodes or other areas.
The survival rate and prognosis of medullary thyroid cancer are directly correlated with the changes in calcitonin concentration after surgery.
After understanding all aspects of medullary thyroid cancer, should we pay more attention to the importance of early screening and early diagnosis to improve survival rate and quality of life?
