What are the symptoms of medullary thyroid cancer? What are the examination methods for medullary thyroid cancer?

The main cause of medullary thyroid cancer is the mutation of the RET oncogene. When symptoms such as unilateral or bilateral thyroid masses, dyspnea, dysphagia, hoarseness, tetany, and carcinoid syndrome occur, one should be alert to the occurrence of medullary thyroid cancer. Women, people between the ages of 30 and 60, and those with a family history of thyroid, parathyroid, and adrenal tumors are susceptible to medullary thyroid cancer and should be careful to prevent it. Medullary thyroid cancer is not actually thyroid cancer. It originates from the thyroid parafollicular cells that secrete calcitonin. They are neuroendocrine cells and have nothing to do with thyroid follicular cells.

Medullary thyroid cancer can be divided into two types: sporadic and hereditary. Hereditary medullary thyroid cancer occurs 10-20 years earlier than sporadic medullary thyroid cancer and is more common in males than in females. Hereditary medullary thyroid cancer is an autosomal dominant genetic disease. Patients with medullary thyroid cancer and their first-degree relatives are tested for the RET oncogene mutation gene.

It is difficult to differentiate thyroid cancer from other thyroid cancers by color Doppler ultrasound examination alone. If the tumor is large, ultrasound-guided puncture examination is a highly sensitive means of diagnosis. If the preoperative calcitonin level is greater than 100 ng/L, it can basically be diagnosed as medullary thyroid cancer. If lung, liver or bone metastasis is suspected, relevant examinations such as lung CT or whole-body bone scan should be performed to make a diagnosis.

Medullary thyroid cancer is insensitive to radiotherapy and chemotherapy. At the same time, the paracrine cells of the thyroid follicles do not absorb iodine. 131I radiotherapy is ineffective for medullary thyroid cancer. Medullary thyroid cancer may spread intraglandularly. The recurrence rate is low after total thyroidectomy. Therefore, regardless of whether it is sporadic or hereditary medullary thyroid cancer, the best surgical method is total thyroidectomy.

There was no statistically significant difference in the effects of different initial symptoms, various stages, different surgical methods for primary lesions, neck lymph node dissection, whether the neck lymph nodes were metastatic, treatment methods, recurrence, and endocrine symptoms such as diarrhea on prognosis.