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Medullary carcinoma of the thyroid gland. A clinicopathologic study of 40 cases
Author(s) -
Gordon P. R.,
Huvos A. G.,
Strong E. W.
Publication year - 1973
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197304)31:4<915::aid-cncr2820310424>3.0.co;2-a
Subject(s) - medicine , thyroid carcinoma , medullary cavity , medullary carcinoma , neck dissection , thyroid , carcinoma , pathology , cancer
Since the first clear descriptions of this distinct variant of thyroid carcinoma by Horn, in 1951, and Hazard et al., in 1959, this clinicopathologic entity has attracted considerable interest because of its familial occurrence and associated neural and endocrine abnormalities. This stimulated us to review and analyze the clinical records and pathologic material of 40 patients with histologically proven medullary carcinoma of the thyroid seen at Memorial‐Sloan Kettering Cancer Center in a 23‐year period (1949–1971). These patients ranged in age from 20 to 75 years with an average of 47.4 years. There was a 21/19 male to female ratio. A neck mass was the most common presenting sign. Only three of the patients had a family history of thyroid carcinoma, and none presented with pheochromocytoma or multiple mucosal neuromas. The histologic appearance of the primary lesions showed a variation in cellular morphology as well as pattern of growth. This variability was not only evident within the primary lesion but in the metastatic sites as well. This important finding bears emphasis, as many observers are unwilling to diagnose medullary carcinoma in the absence of amyloid deposition and are unaware of the variability in the histologic appearance of this tumor. In those patients having a radical neck dissection as part of the initial therapy or at a later date, there was a 66.7% 10‐year survival, while in the patients not having a radical neck dissection the 10‐year survival was slightly less than 43%. Several of the cases had multifocal thyroid involvement, and 75% had proven cervical lymph node metastases. Therefore, it is felt that treatment should include at least a total thyroid lobectomy in conjunction with radical neck dissection.