Learn About Medullary Thyroid Carcinoma

What is the definition of Medullary Thyroid Carcinoma?

Medullary carcinoma of the thyroid is cancer of the thyroid gland that starts in cells that release a hormone called calcitonin. These cells are called "C" cells. The thyroid gland is located inside the front of your lower neck.

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What are the alternative names for Medullary Thyroid Carcinoma?

Thyroid - medullary carcinoma; Cancer - thyroid (medullary carcinoma); MTC; Thyroid nodule - medullary

What are the causes of Medullary Thyroid Carcinoma?

The cause of medullary carcinoma of the thyroid (MTC) is unknown. MTC is very rare. It can occur in children and adults.

Unlike other types of thyroid cancer, MTC is less likely to be caused by radiation therapy to the neck given to treat other cancers during childhood.

There are two forms of MTC:

  • Sporadic MTC, which does not run in families. Most MTCs are sporadic. This form mainly affects older adults.
  • Hereditary MTC, which runs in families.

You have an increased risk for this type of cancer if you have:

  • A family history of MTC
  • A family history of multiple endocrine neoplasia (MEN)
  • A prior history of pheochromocytoma, mucosal neuromas, hyperparathyroidism or pancreatic endocrine tumors

Other types of thyroid cancer include:

  • Anaplastic carcinoma of the thyroid
  • Follicular tumor of the thyroid
  • Papillary carcinoma of the thyroid
  • Thyroid lymphoma
What are the symptoms of Medullary Thyroid Carcinoma?

MTC often begins as a small lump (nodule) in the thyroid gland. There also may be lymph node swelling in the neck. As a result, symptoms may include:

  • Swelling of the neck
  • Hoarseness
  • Breathing problems due to narrowing of airways
  • Cough
  • Cough with blood
  • Diarrhea due to high calcitonin level
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What are the current treatments for Medullary Thyroid Carcinoma?

Treatment involves surgery to remove the thyroid gland and surrounding lymph nodes. Because this is an uncommon tumor, surgery should be performed by a surgeon who is familiar with this type of cancer and experienced with the operation required.

Further treatment will depend on your calcitonin levels. A rise in calcitonin levels again may indicate new growth of the cancer.

  • Chemotherapy and radiation do not work very well for this type of cancer.
  • Radiation is used in some people after surgery.
  • Newer targeted therapies may reduce tumor growth also. Your provider can tell you more about these, if needed.

Near relatives of persons diagnosed with hereditary forms of MTC are at increased risk of this cancer and should discuss with their providers.

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What are the support groups for Medullary Thyroid Carcinoma?

You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.

What is the outlook (prognosis) for Medullary Thyroid Carcinoma?

Most people with MTC live at least 5 years after diagnosis, depending upon the stage of the cancer. The 10-year survival rate is 65%.

What are the possible complications of Medullary Thyroid Carcinoma?

Complications may include:

  • Cancer spreads to other areas of the body
  • Parathyroid glands are accidentally removed during surgery
When should I contact a medical professional for Medullary Thyroid Carcinoma?

Contact your provider if you have symptoms of MTC.

How do I prevent Medullary Thyroid Carcinoma?

Prevention may not be possible. But, being aware of your risk factors, especially your family history, may allow for early diagnosis and treatment. For people who have a very strong family history of MTC, the option to remove the thyroid gland may be recommended. You should carefully discuss this option with a doctor who is very familiar with the disease.

Thyroid cancer - CT scan
Thyroid gland
What are the latest Medullary Thyroid Carcinoma Clinical Trials?
A Phase III, Randomized, Open-Label Study of Pralsetinib Versus Standard of Care for Treatment of RET-Mutated Medullary Thyroid Cancer.

Summary: A study to evaluate the efficacy and safety of pralsetinib compared with SOC treatment (cabozantinib or vandetanib) for participants with RET (rearranged during transfection)-mutant MTC who have not previously received a SOC MultiKinase Inhibitor (MKI) therapy. Participants will be randomized in a 1:1 ratio into one of two treatment arms: Arm A (pralsetinib) or Arm B (investigator's choice of eith...

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Longitudinal Assessment and Natural History Study of Children and Adults With MEN2A or MEN2B With or Without Medullary Thyroid Carcinoma

Background: - Medullary thyroid cancer (MTC) is a rare cancer of the thyroid gland. In children and adults, it is often part of a condition called Multiple Endocrine Neoplasia 2 (MEN2). MEN2 is usually caused by a genetic mutation, and it can cause a number of problems in addition to MTC. These problems include adrenal gland tumors, hormone changes, and problems with the bones and other organs. Not much is kn...

What are the Latest Advances for Medullary Thyroid Carcinoma?
Lobectomy may be more appropriate for patients with early-stage medullary thyroid cancer older than 60 years old.
Total thyroidectomy vs thyroid lobectomy for localized medullary thyroid cancer in adults: A propensity-matched survival analysis.
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Surgical selection and prognostic analysis in patients with unilateral sporadic medullary thyroid carcinoma.
Who are the sources who wrote this article ?

Published Date: January 25, 2022
Published By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Insoo S, Sosa JA. Thyroid. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. Philadelphia, PA: Elsevier; 2022:chap 37.

Jonklass J, Cooper DS. Thyroid. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 213.

National Cancer Institute website. Thyroid cancer treatment (adult) (PDQ) - health professional version. www.cancer.gov/types/thyroid/hp/thyroid-treatment-pdq. Updated February 18, 2022. Accessed June 14, 2022.

Viola D, Elisei R. Management of medullary thyroid cancer. Endocrinol Metab Clin North Am. 2019;48(1):285-301. PMID: 30717909 pubmed.ncbi.nlm.nih.gov/30717909/.

Wells SA Jr, Asa SL, Dralle H. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid. 2015;25(6):567-610. PMID: 25810047 pubmed.ncbi.nlm.nih.gov/25810047/.