Thyroid cancer - medullary carcinoma

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Definition

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.

Alternative Names

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

Causes

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 2 forms of MTC:

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

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

Other types of thyroid cancer include:

Symptoms

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

  • Problems swelling
  • Hoarseness
  • Breathing problems due to narrowing of airways
  • Cough
  • Cough with blood
  • Diarrhea due to high calcitonin level

Exams and Tests

Your health care provider will perform a physical exam and ask about your symptoms and medical history.

Tests that may be used to diagnose MTC include:

People with MTC should be checked for certain other tumors, especially pheochromocytoma.

Treatment

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.

Chemotherapy and radiation do not work very well for this type of cancer. Radiation is used in some people after surgery. New treatments are being investigated in clinical trials. Your provider can tell you more about these, if needed.

Support Groups

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.

Outlook (Prognosis)

About 86% of those with medullary carcinoma of the thyroid live at least 5 years after diagnosis. The 10 year survival rate is 65%.

Possible Complications

Complications may include:

  • Cancer spreads to other areas of the body
  • Parathyroid glands are accidentally removed during surgery

When to Contact a Medical Professional

Call your provider if you have symptoms of medullary carcinoma of the thyroid.

Prevention

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.

References

National Cancer Institute. PDQ thyroid cancer treatment. Bethesda, MD: National Cancer Institute. Updated February 4, 2016. www.cancer.gov/cancertopics/pdq/treatment/thyroid/HealthProfessional. Accessed April 4, 2016.

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: thyroid carcinoma. Version 2.2015. www.nccn.org/professionals/physician_gls/PDF/thyroid.pdf. Accessed April 4, 2016.

Schneider DF, Mazeh H, Lubner SJ, Jaume JC, Chen H. Cancer of the endocrine system. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier; 2014:chap 71.

Version Info

  • Last reviewed on 3/16/2016
  • 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, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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