Luis Cruz-Benítez, Department of Surgical Oncology, HRAEI, SS, Ixtapaluca, Mexico
Angélica Julián-Castrejón, Department of Maxillofacial Surgery, HRAEI, SS, Ixtapaluca, Mexico
Juan de Dios Pérez-Reyna, General Surgery 4th Year Resident, Hosp. Gral. Dr. Darío Fernández Fierro, ISSSTE, Mexico City, Mexico
Medullary thyroid cancer is a neoplasm of the C cells, the function of which is to regulate calcium metabolism. It has a low incidence rate, accounting for 5% of all thyroid cancers. Its occurrence is usually sporadic (84%) or hereditary (16%), with the latter occurring within the context of familial medullary thyroid cancer or multiple endocrine neoplasia type 2, which is associated with different mutations of the proto-oncogene RET 4. It is characterized by secreting calcitonin, which is a useful marker for staging, residual disease detection, and long-term patient follow-up. It is a relatively aggressive neoplasm since despite its slow progression, 60-80% of cases have lymph node metastases at diagnosis, which hinders fully curative therapy since more than 50% of patients have been observed to maintain elevated calcitonin levels after the first surgery. Patients with the hereditary form tend to be younger and to experience more aggressively evolving disease, with cancer often being multifocal and bilateral. The first line of therapy is surgery.
Keywords: Medullary cancer. Papillary cancer. Total thyroidectomy. Radical neck resection. Metastasis
