Medullary thyroid carcinoma: a 20-year experience from a centre in South India.
BACKGROUND
Management of medullary thyroid carcinoma (MTC) remains controversial despite many advances over the past five decades. We attempt to review the presentation, management and prognosis of MTC at our institution over the last two decades.


METHODS
We conducted a retrospective review of the records of 40 patients with MTC over a period of 20 years.


RESULTS
Ten patients had hereditary MTC and 30 had sporadic MTC. The mean age of presentation was 41 years. Sixty-five per cent of the patients had a definite thyroid swelling and 43% had lymphadenopathy at the time of presentation. Total thyroidectomy with a central neck dissection was carried out in 82.5% of patients. Adjuvant therapy was given in 75% of patients because of extensive/residual disease. Postoperative hypercalcitoninaemia was seen 73% of patients. (131)I metaiodobenzylguanidine scanning was carried out in 16 patients with persistent hypercalcitoninaemia; the uptake was positive in 10 and negative in 6, indicating a positivity of 62%.


CONCLUSIONS
Medullary thyroid carcinoma accounts for 2.5% of thyroid carcinomas. There is a small male preponderance. In our series (131)I metaiodobenzylguanidine scan had a better positivity than what has been reported in the published work. Persistent postoperative hypercalcitoninaemia was associated with a poorer prognosis that did not reach statistical significant.
Finny
Philip
P
Department of Endocrinology, Christian Medical College, Vellore, Tamilnadu, India.
Jacob
Jubbin J
JJ
Thomas
Nihal
N
Philip
Jim
J
Rajarathnam
Simon
S
Oommen
Regi
R
Nair
Aravindan
A
Seshadri
Mandalam S
MS
D000293:Adolescent; D000328:Adult; D000368:Aged; D002116:Calcitonin / Q000097:blood; D018276:Carcinoma, Medullary / Q000097:blood / Q000175:diagnosis* / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000601:surgery*; D013965:Thyroidectomy
D002116:Calcitonin