Author:
Yukina M. Yu,Troshina E. A,Beltsevich D. G,Rumyantsev P. O
Abstract
In hereditary MTC recommended age surgery in carriers of the mutation depends on its localization in the gene RET, which determines the probable age of tumor onset, aggressiveness and prognosis of its clinical course. The optimal treatment of the carrier RET mutation is generally recognized preventive thyroidectomy in childhood before the possible onset of malignancy. The only radical treatment of MTC in operable patients is surgical. Regardless of the etiology ( sporadic, familial) MTC is prone to early and extensive metastatic dissemination. The minimum volume of transactions in medullary carcinoma is total thyroidectomy, supplemented with central lymph node dissection. When tumor is operable and in the absence of data for distant metastases should seek to limit the surgical radicality. Clinical supervision with recurrent dinamics assessment of basal and stimulated calcitonin and carcinoembryonic antigen level after the surgery is indicated. In inoperable cases and after progression of distant metastases treatment options are extremely limited. MTC is a radiosensitive tumor. Chemotherapy has shown very limited effectiveness under high toxicity and therefore is not assigned. Satisfactory anti-tumor effect in moderate toxicity showed some tyrosine kinase inhibitors on the results of recent randomized clinical trials.