1. What is distinctive about medullary thyroid cancer?
It arises from thyroid parafollicular C cells and can secrete calcitonin and carcinoembryonic antigen. About 25% is hereditary and associated with RET mutations,
2. What are the early symptoms of medullary thyroid cancer?
It presents as thyroid nodules or neck lumps, sometimes with hoarseness or difficulty swallowing. Some patients develop hormone-related symptoms such as diarrhea and facial flushing,
3. What types of medullary thyroid cancer surgery are available?
Standard surgery is total thyroidectomy with bilateral central compartment lymph node dissection. Resection is more extensive than for differentiated thyroid cancer because medullary carcinoma readily spreads through lymphatics.
4. What is minimally invasive treatment for medullary thyroid cancer?
Endoscopic or robot-assisted total thyroidectomy may be considered for small, localized early lesions. Lymph node dissection can also be performed minimally invasively.
5. What targeted therapies are available for medullary thyroid cancer?
Multitarget tyrosine kinase inhibitors such as vandetanib and cabozantinib are used for advanced medullary thyroid cancer.
6. How are families with hereditary medullary thyroid cancer managed?
A hereditary diagnosis requires RET testing and family screening. First-degree relatives should undergo genetic testing, and mutation carriers require regular calcitonin monitoring.
7. What follow-up is needed after medullary thyroid cancer treatment?
Long-term postoperative calcitonin and carcinoembryonic antigen monitoring assesses response and recurrence. Regular neck ultrasound and whole-body imaging are needed.
