Persistent hypercalcitoninemia in patients with medullary thyroid cancer.

Medullary thyroid carcinoma is a highly malignant and progressive disease. Surgery is the only effective treatment. Calcitonin is a significant marker for medullary thyroid carcinoma, and due to its sensitivity it represents a useful tool for the follow-up. The outcome of patients affected by medullary thyroid carcinoma depends on tumor size, lymph node involvement, and adequacy of primary surgical management. In the present study, the authors reviewed their own experience in the cure of medullary thyroid carcinoma. Forty-one patients operated for sporadic medullary thyroid carcinoma were included. Indications for surgery, inclusive of lymphectomy techniques, timing of redo surgery, and the meaning of calcitonin levels in highlighting disease are extensively discussed. Patients with elevated calcitonin levels and favorable outcome are considered, together with the various diagnostic tools to be employed during patient workup.

[Thyroidectomy for thyroid carcinoma. Our experience]. / Linfectomia per carcinoma della tiroide. Nostra esperienza.

The surgical management of thyroid carcinoma involves different degrees of lymphadenctomy, according to features such as the nature, the site and the severity of the disease. The authors present their experience in order to contribute to the debate on the standard management of nodal metastasis in well-differentiated thyroid cancers. The authors describe their six years of experience in 302 thyroid cancer patients with a total of 291 thyroidectomies performed. According to the different pathological findings, the treatment involved a monolateral dissection in 42 patients and a bilateral modified neck dissection in 21. A number of anatomical considerations regarding the pathway of lymphatic drains are summarized and follow-up results are also presented. The slow progression of the disease and its low incidence make long-term prospective studies difficult, thus hindering any definitive assessment of lymph node management in well-differentiated thyroid cancers.

[Medullary cancer arised in cervical accessory thyroid. Case report]. / Carcinoma midollare insorto su tiroide accessoria cervicale. Considerazioni su un caso clinico.

The Authors present a recent case of a medullary thyroid cancer arised in an ectopic accessory gland, whose definitive diagnosis was only set after the pathologist observation of the resected specimen. The Authors then review the causes of the anomaly and the literature classification of thyroid ectopies together with the commonest clinical, laboratory and imaging diagnostic features. In conclusion Authors indicate the importance of thinking about the possible ectopic thyroidal nature of an undiagnosed cervical mass, in order to recognize an unusual disease thus avoiding a delayed therapy.