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Treatment Implications

Melvin A. Block, MD; Charles E. Jackson, MD; Kenneth A. Greenawald, MD; Joann B. Yott, RN; Armen H. Tashjian, Jr, MD

Arch Surg. 1980;115(2):142-148.

Abstract
• Distinctive differences between the hereditary and sporadic varieties of medullary thyroid carcinoma include the uniform bilaterality, consistent association of C cell hyperplasia, and the frequent association with other endocrine lesions as characteristics of the hereditary type. Total thyroidectomy is required for hereditary medullary thyroid carcinoma. Lateral cervical lymph node dissections do not appear necessary for the hereditary type when not palpable, detected only by family screening, and when biopsy of midjugular lymph nodes shows no evidence of metatasis. For palpable medullary thyroid carcinoma, the eradication of all cervical locations is unlikely to result in normal or undetectable levels of serum calcitonin postoperatively, even though such appears more likely for the sporadic variety.

(Arch Surg 115:142-148, 1980)

Author Affiliations
From the Departments of Surgery (Dr Block), Medicine (Dr Jackson and Ms Yott), and Pathology (Dr Greenawald), Henry Ford Hospital, Detroit; the Department of Pharmacology, Harvard Medical School and the Laboratory of Toxicology, Harvard School of Public Health, Boston (Dr Tashjian).

Footnotes
Accepted for publication June 8, 1979.

Read before the 14th International Congress of Genetics, Moscow, Aug 23, 1978, and the annual meeting of the American Thyroid Association, Portland, Ore, Sept 14, 1978.

Reprint requests to Scripps Clinic Medical Group, 10666 N Tonrey Pines Rd, La Jolla, CA 92037 (Dr Block).

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