Surgical Strategies and Methods for the Treatment of Metastasizing Medullary Thyroid Carcinoma

摘要: The medullary thyroid carcinoma (MTC) exhibits several biological peculiarities. early formation of metastases in the local lymph nodes neck region and proximal mediastinum is particular importance for development therapeutic regimens (Bergholm et al. 1989; Buhr 1991; Duh Graze 1978). Considering patients with elevated basal calcitonin values which were detected during family screening programs Wells (1978b) demonstrated 50% a node involvement. Patients clinically manifest tumors suffered 71% from metastases. Similarly, found 9% mediastinal secondaries 8% occult familial C-cell carcinomas characterized by normal levels but pathological elevations upon pentagastrin stimulation. prognostic relevance classic work Woolner (1969). 10-year survival rate without involvement reached 85% was not significantly different to reference population. In it reduced 42%. These reports further substantiated other authors Roka 1982; Saad 1984; Schroder 1988; Wahl 1987). Since distant occur only late natural history disease, surgical eradication can prolong patient’s life even achieve higher cure rates (Tisell 1986). tumor cells are relatively radio- chemoresistant, intervention highly indicated (Pertursson Samaan Scherubl 1990).