Thyroid cancer is a highly curable cancer, The most common type of thyroid cancer is what a type known as papillary carcinoma. There is a rarer variety of thyroid cancer known as medullary carcinoma of thyroid. Medullary carcinoma of thyroid accounts for about 5 % of the thyroid cancers. Though rare is important to know about medullary carcinoma as it has many special features as compared to papillary carcinoma.
So how does medullary carcinoma of thyroid differ from papillary carcinoma- There is a higher chance that medullary carcinoma of thyroid is hereditary as compared to papillary carcinoma. About 20 percent of medullary carcinomas can be familial. Familial medullary carcinomas can sometimes be associated with other cancers like parathyroid and pheochromocytomas. Familial types can be identified in many cases by doing a gene test known as RET proto-oncogene.
- It is however worth remembering that majority of medullary carcinoma thyroids are still sporadic (not hereditary). Genetic testing is recommended in all cases of medullary carcinomas to know which are familial and which are not.
- There is a tumour marker known as calcitonin which is very useful in case of medullary cancer thyroid. The higher the calcitonin the more the chance of spread to lymph nodes and distant metastases. Calcitonin is very useful in determining the extent of surgery and to detect metastases on follow up.
- A more extensive surgery is required for medullary carcinoma of the thyroid as compared to papillary carcinoma. Total thyroidectomy is always done for medullary carcinomas where as in very early cases of papillary carcinoma with favourable risk hemithyroidectomy may be sufficient.
- It is very important to address lymph nodes in the neck for medullary carcinomas of the thyroid. The surgery performed is known as a neck dissection. Depending on the extent of lymph node involvement a central or lateral compartment neck dissection may be recommended.
- Unlike papillary carcinoma of the thyroid radioiodine is not useful in medullary carcinomas.
- Radiation is sometimes used in medullary carcinomas where the burden of disease in the neck is high.
Medullary thyroid cancers need expert surgical expertise as very often they are inadequately treated.
If you wish further consultation regarding treatment of this condition you can contact Dr Anil Kamath. The contact information is provided in the website .