Endocrine Abstracts

Introduction: medullary thyroid carcinoma (MTC) is a neuroendocrine thyroidal cancer. World Health Organization recognizes a grading system for almost all neuroendocrine tumors; however, a shared grading system for MTC is still lacking. We performed a clinical and pathological review of 257 MTCs to evaluate which histologic features have an impact on the disease specific survival and to propose a new grading system.Method: We retrospectively reviewed cli...

Background: Vandetanib and Cabozantinib are the only two multitarget tyrosine kinase inhibitors approved for the management of metastatic and progressive medullary thyroid cancer. (MTC) Despite their efficacy in terms of progression free survival prolongation and overall response rate, the drug-related toxicity is still a clinical problem, impairing patient’s quality of life and the compliance to the treatment. We retrospectively evaluate the adverse events (AEs) occurred...

Background: Serum calcitonin (CT) is a very sensitive test for the diagnosis of medullary thyroid carcinoma (MTC). However, its routine dosage in patients with nodular thyroid disease is not recommended by all scientific societies. In addition, to optimize costs, it is only suggested in the case of suspicious nodules on ultrasound, indeterminate nodules at cytology or nodular goiter before surgery. The aim of the study is to evaluate the serum CT in a series of consecutive MTC...

Introduction: MTC is a rare neuroendocrine tumor arising from thyroid parafollicular cells. After initial treatment, patients should be divided according to their clinical status in cured, biochemical persistence (BIO) and structural persistence (STR) of the disease. Concerning BIO patients less is known about the structural disease appearance rate and the time elapsed between the first evaluation after surgery and the appearance of structural disease.Me...

Aims: Surgery is the only curative treatment for medullary thyroid cancer (MTC) patients and the gold standard practice is still represented by total thyroidectomy and prophylactic central neck compartment lymphnode dissection. As it happened for differentiated thyroid cancer, in the last years some authors proposed less aggressive and extent surgical modality as hemithyroidectomy and ipsilateral neck compartment dissection in unilateral and solitary sporadic MTC cases. Few st...

Introduction: An increased Body Mass Index (BMI) has been associated with higher prevalence of many cancers, including differentiated thyroid cancer. However, no data have been reported about potential impact of BMI on aggressiveness of presentation and clinical outcome of medullary thyroid cancer (MTC).Aim: To evaluate the potential influence of BMI on clinical presentation and outcome of MTC.Methods: We reviewed anthropometric an...

Introduction: Total thyroidectomy (TT) plus central neck compartment (CC) lymphnode dissection is still the recommended initial gold standard treatment for medullary thyroid cancer (MTC), even in the absence of a pre-surgical positive neck US evidence of lymphnode metastases. Considering the risk of surgical complications of this prophylactic surgery and the low rate of histologic finding of CC lymphnode metastases, a more tailored lymphnode’ surgery should be proposed. A...

Background: Distant metastases at diagnosis is the worst prognostic factor for disease specific survival (DSS) in sporadic medullary thyroid carcinoma (MTC). Also, lymph node metastases are negative prognostic factors both for DSS and recurrence free survival (RFS). The question whether central (N1a) and latero-cervical compartment lymph nodes metastasis (N1b), separately evaluated, can have a different impact on DSS and RFS remains to be clarified.Patie...

Introduction: RET gene is responsible for various human cancers and is mutated and hyperactivated in nearly 100% of familial (germline mutation) and in about 60% of sporadic (somatic mutation) MTC cases. Moreover, RET gene play a role in several physiologic and pathologic conditions. Very recently, the hyperfunction of RET was found to be a key process in weight loss. The hypothesis is that in a peculiar population in which RET gene is mutated and constitutively activated from...

Background: Genotype-phenotype correlations between various RET mutations and clinical manifestations of MEN 2 syndrome are well established. A discussion is still open if the FMTC phenotype really exists or if it is just a MEN2A variant. Aim of this study was to verify if the phenotype corresponding to the V804M germline mutation is restricted to FMTC.Methods: During the last 25 years, we have identified 200 families with a hereditary form of M...