title: [Surgical management of medullary thyroid carcinoma. Personal experience].
abstract: BACKGROUND
  Medullary Thyroid Carcinoma (MTC) is a rare malignancy of the parafollicular C cells of the thyroid gland. Aim of our study is reporting retrospective analysis of our experience about the surgical treatment of MTC, especially pointing on lymphadenectomy.
  
  
  METHODS
  from January 2000 to March 2006, were performed 546 thyroidectomy, 6 of them for MTC (1.09%): 5 sporadic and 1 familiar. All the patients were operated with standard technique (total thyroidectomy) and submitted to endocrinologic and instrumental follow-up.
  
  
  RESULTS
  in our experience, we do not registered early or late complications as bleeding, laryngeal nerves lesions and parathyroid lesions or intra-postoperative deaths.
  
  
  CONCLUSIONS
  MTC occurs sporadically or as part of the multiple endocrine neoplasia type 2 (MEN 2 a/b) syndromes in patients who have inherited a mutation in the RET proto-oncogene. The diagnosis is made by fine needle aspiration biopsy (FNAB) and by measuring calcitonin levels in the blood. Primary treatment consists of surgical resection including a total thyroidectomy, central neck nodal dissection and functional lateral neck nodal dissections. Most patients with a palpable primary tumour have nodal disease at the time of operation, and nodal involvement is often bilateral.
  
  
  CONCLUSIONS
  adequate resection of the primary tumour and cervical lymph nodes is important to optimize outcome and minimize the risk of recurrent disease. Following primary surgical resection, more than 50% of the patients will have recurrent disease with persistent elevation of calcitonin levels. Currently, there is no adequate systemic therapy for recurrent disease. Surgical reoperation or conservative observation are the best available options.
authors.affiliation: Universitá degli Studi di Palermo, Palermo.
authors.forename: G
authors.initials: G
authors.lastname: Geraci
authors.forename: F
authors.initials: F
authors.lastname: Pisello
authors.forename: A
authors.initials: A
authors.lastname: Tornambè
authors.forename: L
authors.initials: L
authors.lastname: Platia
authors.forename: C
authors.initials: C
authors.lastname: Sciumè
authors.forename: F
authors.initials: F
authors.lastname: Li Volsi
authors.forename: F
authors.initials: F
authors.lastname: Cupido
authors.forename: G
authors.initials: G
authors.lastname: Modica
mesh_terms: D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle; D018276:Carcinoma, Medullary / Q000175:diagnosis / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D011379:Prognosis; D000090063:Proto-Oncogene Mas; D012189:Retrospective Studies; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods