Original Scientific Reports

World Journal of Surgery

, Volume 28, Issue 4, pp 397-401

Incidentally Found Medullary Thyroid Cancer: Treatment Rationale for Small Tumors

  • Andreas RaffelAffiliated withDepartment of General and Trauma Surgery, Heinrich-Heine University Email author 
  • , Kenko CupistiAffiliated withDepartment of General and Trauma Surgery, Heinrich-Heine University
  • , Markus KrauschAffiliated withDepartment of General and Trauma Surgery, Heinrich-Heine University
  • , Achim WolfAffiliated withDepartment of General and Trauma Surgery, Heinrich-Heine University
  • , Klaus-Martin SchulteAffiliated withDepartment of General and Trauma Surgery, Heinrich-Heine University
  • , Hans-Dietrich RöherAffiliated withDepartment of General and Trauma Surgery, Heinrich-Heine University

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

The object of this study was to assess the extent of surgery required for small sporadic medullary thyroid cancers (sMTCs). We retrospectively studied 261 patients with MTCs treated in our institution between 1986 and 2002 and identified 15 patients with small pT1 or pT2 sMTCs. The tumors were diagnosed incidentally, so surgical therapy was less than total thyroidectomy. Total thyroidectomy with or without neck dissection was applied to all other patients as standard surgical treatment of care. Patients were systematically followed up by postoperative ultrasonography, calcitonin, carcinoembryonic antigen levels, and pentagastrin stimulation tests. On long-term follow-up over a period of 4.6 years, the rate of biochemical cure in these patients who underwent less than total thyroidectomy for a sporadic incidentally diagnosed tumor was 100%. We concluded that completion thyroidectomy and neck dissection are not mandatory in patients in whom a solitary small sMTC is incidentally discovered by histologic diagnosis following operation so long as a genetic background is excluded. Nevertheless, such patients require systematic careful long-term follow-up.