How is medullary thyroid carcinoma (MTC) treated?

Updated: May 14, 2020
  • Author: Pramod K Sharma, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Both sporadic MTCs and FMTCs are treated with total thyroidectomy and lymphatic dissection of the anterior compartment of the neck (level VI). If the vasculature of the parathyroid gland is disrupted, autotransplantation of the parathyroid gland into the sternocleidomastoid muscle or the nondominant forearm is performed.

Metastasis to the cervical lymph nodes is common in patients with MTC, particularly those with familial forms with multicentricity and bilaterality of the primary tumor. Lymph node metastases can occur in more than 50% of patients. Both before and at the time of surgery, the lateral jugular lymphatics should carefully be palpated for evidence of metastatic disease. Selective neck dissection (sparing nonlymphatic structures when possible) of levels II, III, IV, and V is performed when metastases are clinically evident.

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