Medullary Thyroid Cancer
Actually, medullary thyroid cancer is not a thyroid cancer at all.
Metastasis to the lymph nodes in the neck and distant spread are possible.
Actually, medullary thyroid cancer is not a thyroid cancer at all. It is a cancer of what are called “C-cells”, that happen to be located in the thyroid gland. C- cells produce a hormone called Calcitonin, a chemical that has a complicated and still somewhat ill-defined effect on calcium metabolism. Suffice to say, a patient with a thyroid tumor and elevated levels of Calcitonin in the bloodstream must be considered to have a Medullary cancer of the thyroid until proven otherwise.
Medullary cancer is most often just a sporadic disease for which no genetic or familial relationship is identified. Some, however, are definitely passed on genetically, and some are part of very rare syndromes called Multiple Endocrine Neoplasia, a topic that is beyond the scope of this brief essay.
Medullary cancers can be very aggressive and fatal while others may be more slow growing and indolent in their behavior. Metastasis to the lymph nodes in the neck and distant spread are always possible. Measurement of the blood concentration of Calcitonin is a good way to follow up on these patients. An increase in Calcitonin levels after surgery may signal recurrent or metastatic disease. Unfortunately, since this is not truly a cancer of thyroid origin, the cells do not absorb Iodine, and therefore, radioactive Iodine treatment is not effective. This underscores the need for an early and aggressive surgical approach to this disease. This is another good example of where partial thyroidectomies and less than complete neck dissections are to be condemned.