scholarly journals Video mediastinoscopy-assisted superior mediastinal dissection in the treatment of thyroid carcinoma with mediastinal lymphadenopathy: preliminary results

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuntao Song ◽  
Liang Dai ◽  
Guohui Xu ◽  
Tianxiao Wang ◽  
Wenbin Yu ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Mediastinal Lymph Node ◽  
Mediastinal Lymphadenopathy ◽  
Medullary Thyroid ◽  
Mediastinal Dissection ◽  
Fatal Bleeding ◽  
Postoperative Serum ◽  
Chyle Fistula

Abstract Background Mediastinal lymph node metastases (MLNM) are not rare in thyroid cancer, but their treatment has not been extensively studied. This study aimed to explore the preliminary application of video mediastinoscopy-assisted superior mediastinal dissection in the diagnosis and treatment of thyroid carcinoma with mediastinal lymphadenopathy. Materials and methods We retrospectively reviewed the clinical pathologic data and short-term outcomes of thyroid cancer patients with suspicious MLNM treated with video mediastinoscopy-assisted mediastinal dissection at our institution from 2017 to 2020. Results Nineteen patients were included: 14 with medullary thyroid carcinoma and five with papillary thyroid carcinoma. Superior mediastinal nodes were positive in nine (64.3%) patients with medullary thyroid carcinoma and in four (80.0%) patients with papillary carcinoma. No fatal bleeding occurred. There were three cases of temporary recurrent laryngeal nerve (RLN) palsy postoperatively, one of which was bilateral. Four patients had temporary hypocalcemia requiring supplementation, one had a chyle fistula, and one developed wound infection after the procedure. Postoperative serum molecular markers decreased in all patients. One patient died of cancer while the other 18 patients remained disease-free, with a median follow-up of 33 months. Conclusion Video mediastinoscopy-assisted superior mediastinal dissection can be performed relatively safely in patients with suspicious MLNM. This diagnostic and therapeutic approach may help control locoregional recurrences.

Article Commentary: Medullary Thyroid Cancer: An Update for Surgeons

2015 ◽  
Vol 81 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Faris K. Azar ◽  
Stephanie L. Lee ◽  
Jennifer E. Rosen
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Progressive Disease ◽  
Medullary Thyroid Cancer ◽  
Germline Mutations ◽  
Current Management ◽  
Future Directions ◽  
Medullary Thyroid ◽  
Individualized Management

Medullary thyroid carcinoma is uncommon but accounts for approximately 4 to 5 per cent of all thyroid cancers. Although most cases are sporadic, close to one-fourth of cases result from germline mutations in the RET proto-oncogene. These mutations are clinically important because they predict the earliest age of medullary thyroid cancer diagnosis and clinical aggressiveness, which guide individualized management. This review covers the presentation, diagnosis, workup, current management, and future directions of the management of medullary thyroid carcinoma. Today's chance for cure depends on early and appropriate surgical resection. Further investigation of the cellular signaling pathways shown to be essential for the growth and spread of medullary thyroid carcinoma remains an active field with hope for providing targeted systemic therapy for patients with progressive disease.

Prophylactic thyroidectomy as method of medullary thyroid carcinoma prevention in children from MEN syndrom families

2017 ◽  
Vol 8 (5) ◽  
pp. 5-11
Author(s):  
Zoya S. Matveeva ◽  
Anatoliy F. Romanchishen ◽  
Alexandr V. Gostimsky ◽  
Kristina V. Vabalayte
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Multiple Endocrine Neoplasia ◽  
Medullary Thyroid Cancer ◽  
Parathyroid Glands ◽  
Medullary Thyroid ◽  
Endocrine Neoplasia ◽  
The Family

The article presents results of diagnostics, surgical treatment and follow-up of patients with rare hereditary-conditioned forms of thyroid cancer – medullary thyroid carcinoma in content of multiple endocrine neoplasia syndrome. Particular attention is paid to the examination and tactics of treatment of children and adolescents with family genetically confirmed Sipple syndrome. The disease is diagnosed in 4 families. Syndrome of multiple endocrine neoplasia 2a type we found in 7 (0.024%) of 29,325 children and adult patients. All the children were from families in which one of the blood relatives suffered medullary thyroid cancer. The family nature of the disease was confirmed by molecular genetic studies that revealed mutations in C634 (T1900C) in the 11 exon of the RET gene. Only in 3 out of 7 cases thyroidectomy was prophylactic. Four children were fond foci of medullary carcinoma in the removed thyroid gland. In total, 22 operations were performed for the members of 4 families suffering from the family syndrome MEN-2a. The article shows that if a patient is diagnosed Sippl's syndrome, all his blood relatives need to be checked for the mutation of the RET gene to identify familial medullary thyroid cancer, adenomas of parathyroid glands and pheochromocytomas. Early removal of the thyroid gland (in children under the age of 5 years) prevents medullary cancer, and timely diagnosis and adequate surgical removal of neoplasms of parathyroid glands and adrenal glands ensure recovery of the patients. Closest relatives should be checked for the level of calcium and calcitonin, catecholamines, vanillylmandelic acid and metanephrine, ACTH, cancer-embryonic antigen.

scholarly journals Sporadic and familial types of medullary thyroid carcinoma

2003 ◽  
Vol 49 (5) ◽  
pp. 45-47
Author(s):  
A. A. Ilyin ◽  
P. O. Rumyantsev ◽  
P. A. Isayev ◽  
V. S. Medvedev ◽  
B. M. Vtyurin ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Medullary Thyroid Cancer ◽  
Medullary Thyroid

This article focuses on sporadic and familial variants of medullary thyroid cancer.

Is familial non-medullary thyroid carcinoma more aggressive than sporadic thyroid cancer? A multicenter series

Surgery ◽  
2000 ◽  
Vol 128 (6) ◽  
pp. 1043-1051 ◽  
Author(s):  
Osamah Alsanea ◽  
Nobuyuki Wada ◽  
Kenneth Ain ◽  
Mariwil Wong ◽  
Kelly Taylor ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Medullary Thyroid
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