Imaging Techniques for Metastatic Thyroid Medullary Cancer

Medullary thyroid carcinoma (MTC) originating from the calcitoninsecreting parafollicular cells is a relatively uncommon disease. It constitutes 3% to 10% of all thyroid malignancies (1). MTC may occur in sporadic or rarely familial form as a part of multiple endocrine neoplasia syndrome type 2A and 2B. The sporadic MTC is mostly detected on the basis of clinical symptoms. Calcitonin that is secreted from the parafollicular C cells is a useful marker for initial diagnosis and follow-up (2). Carcinoembryonic antigen (CEA) can also be used as a tumor marker for MTC (3). Total thyroidectomy with cervical lymph node dissection is the primary therapeutic option for MTC because of the high incidence of lymphatic metastasis (4). At the time of initial diagnosis cervical lymph node metastases have been detected in 7180% of the patients, and mediastinal involvement and distant metastases have been reported in 3620% (5-8) of the patients with MTC, respectively.