title: [Difficulties in diagnosis and localization of recurrent medullary thyroid carcinoma].
abstract: Recurrent and residual medullary thyroid carcinoma (MTC) are common in patients following primary surgical resection. Difficulty arises in performing precise localization of the tumor because of anatomical distortion of the neck structures following surgery. To date, no modality has been shown superior to others in the diagnosis of recurrent or residual MTC, and the issue is currently under debate in the literature. We report a case in which secondary recurrence of MTC was detected and localized using a novel combination of preoperative and intraoperative radionuclide imaging, and a method of preventing intraoperative damage to the recurrent laryngeal nerve in the anatomically disrupted neck. To our knowledge, this is the first report of a combination of these three modalities in detection and localization of recurrent MTC, while minimizing the possibility for nerve injury during the operative procedure. Such a therapeutic strategy may prove useful in the management of patients who have previously undergone neck surgery and suffer from anatomical distortion of normal neck structures.
authors.affiliation: Dept. of Surgery A, Carmel Medical Center, Haifa.
authors.forename: Arie
authors.initials: A
authors.lastname: Biterman
authors.forename: Boaz
authors.initials: B
authors.lastname: Bloch
authors.forename: Tamir
authors.initials: T
authors.lastname: Wolf
authors.forename: Ela
authors.initials: E
authors.lastname: Baron
authors.forename: Oleg
authors.initials: O
authors.lastname: Lephel
authors.forename: Oded
authors.initials: O
authors.lastname: Cohen
mesh_terms: D018276:Carcinoma, Medullary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D018365:Neoplasm, Residual / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D011877:Radionuclide Imaging; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery