Medullary thyroid carcinoma
DOI:
https://doi.org/10.24220/2318-0897v19n1/6a833Keywords:
Calcitonin, carcinoma, Thyroid gland, Screening massAbstract
Medullary thyroid carcinoma is characterized by specific histological properties and by the production of a tumor marker called calcitonin. This neoplasm corresponds to 5 to 10% of all thyroid cancers. Cure or prevention of medullary thyroid carcinoma is usually achieved when genetic screening and/or biochemical programs are used on all members of families that carry the gene, whether associated or not with other endocrine diseases. Determination of the immunohistochemical properties of thyroid cells and serum calcitonin levels has identified patients at high risk of medullary thyroid carcinoma. Thus, this study presents the follow-up of two patients with a history of thyroid disorders in the
family, seen at the Head and Neck Surgery Service of the Jundiaí School of Medicine between January 2008 and November 2009. Both patients were submitted to
thyroidectomy and after one year, they no longer presented symptoms of the disease. The screening program consisted of determining serum calcitonin levels and post-thyroidectomy immunohistochemical, anatomical and pathological analyses, which evidenced features characteristic of medullary thyroid carcinoma.
Early diagnosis and treatment of this neoplasm allow the patient to be cured.
Downloads
References
Siqueira D, Rocha AP, Puñales MK, Maia AL. Identification of occult metastases of medullary thyroid carcinoma by calcitonin measurement in washout fluid from fine needle aspiration of cervical lymph node. Arq Bras Endocrinol Metab. 2009; 53(4):479-81.
Lundgren CI, Delbridg L, Learoyd D, Robinson B. Surgical approach to medullary thyroid câncer. Arq Bras Endocrinol Metab. 2007; 51(5):818-24.
Cote GJ, Gagel RF. Lessons learned from the management of a rare genetic cancer. N Eng J Med. 2003; 349(16):1566-8.
Maciel RMB. Tumorigênese molecular tiroideana: implicações para a prática médica. Arq Bras Endocrinol Metab. 2002; 46(4):381-90.
Goldgar DE, Easton DF, Cannon-Albright LA, Skolnick MH. Systematic population-based assessment of cancer risk in first-degree relatives of cancer probands. J Natl Cancer Inst. 1994; 86(21):1600-8.
Alsanea O, Clark OH. Familial thyroid cancer. Curr Opin Oncol. 2001; 13(1):44-51.
Cerutti JM, Silva AMA. Base genética do carcinoma medular da glândula tireóidea. In: De Carvalho MB. Tratado de tireóide e paratireóide. Rio de Janeiro: Rubio; 2007. p.535-43.
Niccoli-Sire P, Murat A, Rohmer V. Familial medullary thyroid carcinoma with noncysteine RET mutations: phenothype-genotype relationship in a large series of patients. J Clin Endocrinol Metab. 2004; 86(8):3746-53.
Méndez AS, Galavís V, Ablan F, Gallego E, Cardénas K. Medullar carcinoma ofthyroid: a purpouse of a case. Col Med Est Táchira. 2002; 11(3):46-8.
Magalhães PKR, Castro M, Elias LLK. Carcinoma medular de tireóide: da definição às bases moleculares. Arq Bras Endocrinol Metab. 2003; 47(5):5515-28.
Copp MR, Carvalho MB. Tratado de cirurgia de cabeça e pescoço e otorrinolaringologia. Rio de Janeiro: Atheneu, 2001. v.1, p.659.
Cohen R, Campos JM, Salaün C. Pre-operative calcitonin levels are predictive of tumor size and postoperative calcitonin normalization in medullary thyroid carcinoma. J Clin Endocrinol Metab. 2000; 85(2):919-22.
Ezabella MCL, Hayashida CY, Bisi H, Abelin NM, Brandäo LG, Toledo SPA. Early detection of the medullary thyroid carcinoma. Arq Bras Endocrinol Metab. 1990; 34(6):34-6.
Hauache OM, Vieira JGH, Maciel RMB. Diagnóstico laboratorial do carcinoma medular de tiróide: calcitonina basal e testes de estímulo. Arq Bras Endocrinol Metab. 2003; 47(5):529-33.
Correia-Deur JEM, Toledo RA, Imazawa AT, Lourenço Jr DM, Ezabella MCL, Tavares MR, et al. Sporadic medullary thyroid carcinoma: clinical data from a University Hospital. Clinics. 2009; 64(7):379-86.
Horvit PK, Gagel RF. Editorial: the goitrous patient with an elevated serum calcitonin - what to do? J Clin Endocrinol Metab. 1997; 82(2):335-7.
Saller B, Feldmann G, Haupt K. RT-PCR-based detection of circulating calcitonin-producing cells in patients with advanced medullary thyroid cancer. J Clin Endocrinol Metab. 2002; 87(1):292-6.
Kloos RT, Eng C, Evans DB, Francis GL, Gagel RF, Gharib H, et al. Medullary thyroid cancer: management guidelines of the american thyroid association. Thyroid. 2009; 19(6):565-612.
