ECE2017 Eposter Presentations: Thyroid Thyroid (non-cancer) (260 abstracts)
Medullary thyroid carcinoma – diagnosis and outcome of patients treated in a tertiary center
Joanna Prokop , Ana Palha , Teresa Sabino , Carolina Neves , Luísa Cortez , José Silva-Nunes , Cristina Santos , Lurdes Matos , Natércia Candeias , António Afonso , Fernando Fonseca & Ana Agapito
Department of Endocrinology, Centro Hospitalar Lisboa Central, Lisbon, Portugal.
Medullary thyroid carcinoma (MTC) is a rare tumor of C cell origin, that may be sporadic or familial. Diagnosis is often delayed and its course variable.
Objectives: Evaluation of clinical characteristics and outcome of patients diagnosed with MTC.
Methods: Retrospective analysis of clinical records of patients with MTC between 2005 and 2016. We considered undetectable serum calcitonin as criteria of cure.
Results: Sixteen patients (12 women) were observed: mean age at presentation 63.8 years (46–79), mean follow-up: 2.2 years. Thyroid nodules were present in all. Four patients had compressive symptoms, three lymphadenopathy and one chronic diarrhea. Eight patients were diagnosed on the basis of histological examination without previous clinical suspicion of MTC. Genetic testing for RET proto-oncogene mutations was performed in nine patients and in one germinative mutation was detected (isolated familiar MTC). Eight patients with previous suspicion of MTC underwent total thyroidectomy with central lymph node dissection, and in five of these also lateral lymph node dissection. Among patients diagnosed after surgery: two had undergone total thyroidectomy with central lymph node dissection, in one of these combined with lateral node lymph dissection, three total thyroidectomy and three hemithyroidectomy. One completed thyroidectomy and the other two maintain undetectable calcitonin (follow-up: 0.5-1.3 years). After surgery seven patients were cured. One of them suffered recurrence with hepatic metastases 4 years later. Among patients with disease persistence there were six with progression in serum calcitonin, one with radiologic evidence of metastases. This patient had cervical lymph node metastases (calcitonin doubling time-CDT:6 months) 7 years after MTC diagnosis and underwent reoperation without cure.
Discussion: In this cohort of patients MTC diagnosis was made often after surgery (50%), which raises the question of presurgical calcitonin testing. MTC may have indolent or aggressive course as observed in this study, and turns difficult optimal treatment and follow-up strategy in the individual patient.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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