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Early Diagnosis and Treatment of Medullary Thyroid Carcinoma

Early Diagnosis and Treatment of Medullary Thyroid Carcinoma Abstract Medullary thyroid carcinoma (MTC) was first described as a distinct clinical entity by Hazard et al1 in 1959. Although the lesion was previously thought to be a variant of anaplastic thyroid carcinoma, these investigators appreciated that certain histologic characteristics distinguished it from other thyroid neoplasms. Actually, MTC is derived not from follicular or stromal elements but from neural crest cells, which in mammals are incorporated within the thyroid gland. In birds and fish these cells exist as a separate structure called the ultimobranchial body. In retrospect, it is surprising that MTC was not recognized sooner as being different from other thyroid malignant neoplasms because it has certain unique characteristics, including frequent involvement of both thyroid lobes, occurrence in a familial pattern with assocated endocrinopathies (multiple endocrine neoplasia [MEN] types IIa and IIb), the presence in the tumor of a substance with the histochemical staining properties of amyloid, and the References 1. Hazard JB, Hawk WA, Crile G Jr: Medullary (solid) carcinoma of the thyroid: A clinicopathologic entity. J Clin Endocrinol 1959;19:152-161.Crossref 2. Farndon JR, Leight GS, Dilley WG, et al: Familial medullary thyroid carcinoma without associated endocrinopathies: A distinct clinical entity. Br J Surg , in press. 3. Tashjian AH Jr, Hawland BG, Melvin KEW, et al: Immunoassay of human calcitonin: Clinical measurement, relation to serum calcium and studies in patients with medullary thyroid carcinoma. N Engl J Med 1970;283:890-895.Crossref 4. Parthemore JG, Bronzert D, Roberts G, et al: A short calcium infusion in the diagnosis of medullary thyroid carcinoma. J Clin Endocrinol Metabol 1974;39:108-111.Crossref 5. Rude RK, Singer FR: Comparison of serum calcitonin levels after a one-minute calcium injection and after pentagastrin injection in the diagnosis of medullary thyroid carcinoma. J Clin Endocrinol Metabol 1977;44:980-983.Crossref 6. Hennessy JF, Wells SA, Ontjes DA, et al: A comparison of pentagastrin injection and calcium infusion as provocative agents for the detection of medullary carcinoma of the thyroid. J Clin Endocrinol Metabol 1974;39:487-495.Crossref 7. Wells SA, Ontjes DA, Cooper CW, et al: The early diagnosis of medullary carcinoma of the thyroid gland in patients with multiple endocrine neoplasia type II. Ann Surg 1975;182:362-370.Crossref 8. Wells SA, Baylin SB, Linehan WM, et al: Provocative agents in the diagnosis of medullary carcinoma of the thyroid gland. Ann Surg 1978;188:139-141.Crossref 9. Baylin SB, Hsu T, Stevens SA, et al: The effects of L-dopa on in vitro and in vivo calcitonin release from medullary thyroid carcinoma. J Clin Endocrinol Metabol 1979;48:408-414.Crossref 10. Cohen G, Goldenberg M: The simultaneous fluorometric determination of adrenaline and noradrenaline in plasma. J Neurochem 1957;7:58-80.Crossref 11. Pisano JJ, Crout JR, Abraham D: Determination of 3-methoxy-4-hydroxymandelic acid in urine. Clin Chim Acta 1962;7:285-291.Crossref 12. Pisano JJ: Assay of catecholamine metabolites based on vanillin formation , in Rall JE, Kopin IJ (eds): Methods in Investigative and Diagnostic Endocrinology . New York, American Elsevier, 1972, vol 1, pp 474-488. 13. Wells SA Jr, Farndon JR, Dale JK, et al: Long-term evaluation of patients with primary parathyroid hyperplasia managed by total parathyroidectomy and heterotopic autotransplantation. Ann Surg 1980;192: 451-458.Crossref 14. Wells SA Jr, Baylin SB, Johnsrude IS, et al: Thyroid venous catheterization in the early diagnosis of familial medullary thyroid carcinoma. Ann Surg 1982;196:505-511.Crossref 15. Wells SA Jr, Baylin SB, Leight GS, et al: The importance of early diagnosis in patients with hereditary medullary thyroid carcinoma. Ann Surg 1982;195:595-599.Crossref 16. Lippman SM, Mendelsohn G, Trump DL, et al: The prognostic and biologic significance of cellular heterogeneity in medullary thyroid carcinoma: A study of calcitonin, L-dopa decarboxylase and histaminase. J Clin Endocrinol Metabol 1982;54:233-240.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1985 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1985.00360070126021
Publisher site
See Article on Publisher Site

Abstract

Abstract Medullary thyroid carcinoma (MTC) was first described as a distinct clinical entity by Hazard et al1 in 1959. Although the lesion was previously thought to be a variant of anaplastic thyroid carcinoma, these investigators appreciated that certain histologic characteristics distinguished it from other thyroid neoplasms. Actually, MTC is derived not from follicular or stromal elements but from neural crest cells, which in mammals are incorporated within the thyroid gland. In birds and fish these cells exist as a separate structure called the ultimobranchial body. In retrospect, it is surprising that MTC was not recognized sooner as being different from other thyroid malignant neoplasms because it has certain unique characteristics, including frequent involvement of both thyroid lobes, occurrence in a familial pattern with assocated endocrinopathies (multiple endocrine neoplasia [MEN] types IIa and IIb), the presence in the tumor of a substance with the histochemical staining properties of amyloid, and the References 1. Hazard JB, Hawk WA, Crile G Jr: Medullary (solid) carcinoma of the thyroid: A clinicopathologic entity. J Clin Endocrinol 1959;19:152-161.Crossref 2. Farndon JR, Leight GS, Dilley WG, et al: Familial medullary thyroid carcinoma without associated endocrinopathies: A distinct clinical entity. Br J Surg , in press. 3. Tashjian AH Jr, Hawland BG, Melvin KEW, et al: Immunoassay of human calcitonin: Clinical measurement, relation to serum calcium and studies in patients with medullary thyroid carcinoma. N Engl J Med 1970;283:890-895.Crossref 4. Parthemore JG, Bronzert D, Roberts G, et al: A short calcium infusion in the diagnosis of medullary thyroid carcinoma. J Clin Endocrinol Metabol 1974;39:108-111.Crossref 5. Rude RK, Singer FR: Comparison of serum calcitonin levels after a one-minute calcium injection and after pentagastrin injection in the diagnosis of medullary thyroid carcinoma. J Clin Endocrinol Metabol 1977;44:980-983.Crossref 6. Hennessy JF, Wells SA, Ontjes DA, et al: A comparison of pentagastrin injection and calcium infusion as provocative agents for the detection of medullary carcinoma of the thyroid. J Clin Endocrinol Metabol 1974;39:487-495.Crossref 7. Wells SA, Ontjes DA, Cooper CW, et al: The early diagnosis of medullary carcinoma of the thyroid gland in patients with multiple endocrine neoplasia type II. Ann Surg 1975;182:362-370.Crossref 8. Wells SA, Baylin SB, Linehan WM, et al: Provocative agents in the diagnosis of medullary carcinoma of the thyroid gland. Ann Surg 1978;188:139-141.Crossref 9. Baylin SB, Hsu T, Stevens SA, et al: The effects of L-dopa on in vitro and in vivo calcitonin release from medullary thyroid carcinoma. J Clin Endocrinol Metabol 1979;48:408-414.Crossref 10. Cohen G, Goldenberg M: The simultaneous fluorometric determination of adrenaline and noradrenaline in plasma. J Neurochem 1957;7:58-80.Crossref 11. Pisano JJ, Crout JR, Abraham D: Determination of 3-methoxy-4-hydroxymandelic acid in urine. Clin Chim Acta 1962;7:285-291.Crossref 12. Pisano JJ: Assay of catecholamine metabolites based on vanillin formation , in Rall JE, Kopin IJ (eds): Methods in Investigative and Diagnostic Endocrinology . New York, American Elsevier, 1972, vol 1, pp 474-488. 13. Wells SA Jr, Farndon JR, Dale JK, et al: Long-term evaluation of patients with primary parathyroid hyperplasia managed by total parathyroidectomy and heterotopic autotransplantation. Ann Surg 1980;192: 451-458.Crossref 14. Wells SA Jr, Baylin SB, Johnsrude IS, et al: Thyroid venous catheterization in the early diagnosis of familial medullary thyroid carcinoma. Ann Surg 1982;196:505-511.Crossref 15. Wells SA Jr, Baylin SB, Leight GS, et al: The importance of early diagnosis in patients with hereditary medullary thyroid carcinoma. Ann Surg 1982;195:595-599.Crossref 16. Lippman SM, Mendelsohn G, Trump DL, et al: The prognostic and biologic significance of cellular heterogeneity in medullary thyroid carcinoma: A study of calcitonin, L-dopa decarboxylase and histaminase. J Clin Endocrinol Metabol 1982;54:233-240.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jul 1, 1985

References