Abstract
Background:
Medullary thyroid cancer (MTC) represents a rare but significant proportion (7%) of surgically treated thyroid malignancies. This study aimed to demonstrate the clinical characteristics of MTC, focusing on preoperative risk assessment and surgical outcomes.
Method:
Among 343 thyroid malignancies over the 5 years, 24 (7%) were identified as MTC. Genetic testing was conducted in 14 patients, revealing 4 familial cases (FMTC or MEN2a). Risk stratification using EU-TIRADS indicated varying degrees of suspicion (II - 4.2%, III - 16.7%, IV - 37.5%, V - 41.6%). Fine-needle aspiration was performed in 79.2 % of cases, and according to Bethesda classification demonstrated diverse results (II - 12.5%, III - 12.5%, IV - 8.3%, V - 29.2%, VI - 16.7%).
Results:
All patients underwent thyroidectomy. Lymph node dissection was performed in 70.8% (unilateral central in 7, bilateral central in 9, central plus ipsilateral lateral in 6, central plus bilateral lateral in 2). The median tumor size was 12mm. AJCC staging revealed 15 in stage I, 2 in stage II, 1 in stage III, and 6 in stage IVa. Postsurgical biochemical remission -calcitonin <2.5 pg/ml, was achieved in 75% of patients, predominantly in AJCC stage I (83.3%) with a preoperative median calcitonin of 147 pg/ml. Conversely, all detectable calcitonin cases (>2.5 pg/ml) were in AJCC stage IVa with a preoperative median calcitonin of 517 pg/
Conclusion:
MTC, constituting 7% of thyroid malignancies, presents a unique clinical entity within thyroid malignancies, emphasizing the importance of genetic testing and risk stratification in guiding surgical approaches and predicting outcomes.
Medullary thyroid cancer (MTC) represents a rare but significant proportion (7%) of surgically treated thyroid malignancies. This study aimed to demonstrate the clinical characteristics of MTC, focusing on preoperative risk assessment and surgical outcomes.
Method:
Among 343 thyroid malignancies over the 5 years, 24 (7%) were identified as MTC. Genetic testing was conducted in 14 patients, revealing 4 familial cases (FMTC or MEN2a). Risk stratification using EU-TIRADS indicated varying degrees of suspicion (II - 4.2%, III - 16.7%, IV - 37.5%, V - 41.6%). Fine-needle aspiration was performed in 79.2 % of cases, and according to Bethesda classification demonstrated diverse results (II - 12.5%, III - 12.5%, IV - 8.3%, V - 29.2%, VI - 16.7%).
Results:
All patients underwent thyroidectomy. Lymph node dissection was performed in 70.8% (unilateral central in 7, bilateral central in 9, central plus ipsilateral lateral in 6, central plus bilateral lateral in 2). The median tumor size was 12mm. AJCC staging revealed 15 in stage I, 2 in stage II, 1 in stage III, and 6 in stage IVa. Postsurgical biochemical remission -calcitonin <2.5 pg/ml, was achieved in 75% of patients, predominantly in AJCC stage I (83.3%) with a preoperative median calcitonin of 147 pg/ml. Conversely, all detectable calcitonin cases (>2.5 pg/ml) were in AJCC stage IVa with a preoperative median calcitonin of 517 pg/
Conclusion:
MTC, constituting 7% of thyroid malignancies, presents a unique clinical entity within thyroid malignancies, emphasizing the importance of genetic testing and risk stratification in guiding surgical approaches and predicting outcomes.
| Original language | English |
|---|---|
| Pages | 1 |
| Publication status | Published - 2024 |
| Externally published | Yes |
| Event | 10th Biennial Congress of the European Society of Endocrine Surgeons - Rome, Italy Duration: 23 May 2024 → 25 May 2024 https://www.eses2024.org/ |
Congress
| Congress | 10th Biennial Congress of the European Society of Endocrine Surgeons |
|---|---|
| Country/Territory | Italy |
| City | Rome |
| Period | 23/05/24 → 25/05/24 |
| Internet address |
Field of Science*
- 3.2 Clinical medicine
Publication Type*
- 3.4. Other publications in conference proceedings (including local)
