Skip to main content

Medullary Thyroid Carcinoma

  • Chapter
  • First Online:
Molecular Pathology of Endocrine Diseases

Part of the book series: Molecular Pathology Library ((MPLB,volume 3))

Abstract

Medullary thyroid carcinoma (MTC) is currently defined as a malignant thyroid tumor with evidence of C-cell differentiation.1,2 While earlier reports had alluded to the existence of this tumor type, Robert Horn in 1951 reported a series of 7 cases of a thyroid cancer characterized by sharply defined rounded or ovoid compact cell groups of moderate size in a background of hyalinized connective tissue.3 He noted that “while not pursuing the rapid course characteristic of the giant cell, spindle cell and small cell thyroid carcinoma, these tumors have by no means the favorable prognosis of malignant adenoma and papillary tumors”. The major histopathologic features of this tumor, including the presence of stromal amyloid deposits, were defined in 1959 by Hazard and coworkers who suggested the term, medullary thyroid carcinoma (MTC).4

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Rosai J, Carcangiu MI, DeLellis RA. Tumors of the Thyroid Gland Atlas of Tumor Pathology. Armed Forces Institute of Pathology: Washington, DC; 1992:207–258.

    Google Scholar 

  2. Matias-Guiu X, DeLellis RA, Moley JF, et al. Medullary thyroid carcinoma. In: DeLellis RA, Lloyd RV, Heitz PU, Eng C, eds. Pathology and Genetics of Tumours of Endocrine Organs. WHO Classification of Tumours. Lyon: IARC Press; 2004:86–91.

    Google Scholar 

  3. Horn RC. Carcinoma of the thyroid. Description of a distinctive morphological variant and report of seven cases. Cancer. 1951;4:697–707.

    Article  Google Scholar 

  4. Hazard JB, Hawke WA, Crile G. Medullary (solid) carcinoma of the thyroid: a clinicopathological entity. J Clin Endocrinol Metab. 1959;19:152–161.

    Article  PubMed  CAS  Google Scholar 

  5. Williams ED. Histogenesis of medullary carcinoma of the thyroid. J Clin Pathol. 1966;19:114–118.

    Article  PubMed  CAS  Google Scholar 

  6. Bussolati G, Pearse AGE. Immunofluorescent localization of calcitonin in the ‘C’-cells of the dog and pig thyroid. J Endocrinol. 1967;37:205–209.

    Article  PubMed  CAS  Google Scholar 

  7. Tashjian AH, Melvin EW. Medullary carcinoma of the thyroid gland. Studies of thyrocalcitonin in plasma and tumor extracts. N Engl J Med. 1968;279:279–283.

    Article  PubMed  Google Scholar 

  8. Melvin KE, Miller HH, Tashjian AH Jr. Early diagnosis of medullary carcinoma of the thyroid means of calcitonin assay. N Engl J Med. 1971;285:1115–1120.

    Article  PubMed  CAS  Google Scholar 

  9. DeLellis RA, Wolfe HJ. The pathology of human calcitonin (C)-cell. Annu Rev Pathol. 1981;16:25–52.

    CAS  Google Scholar 

  10. Pacini F, Fontanelli M, Fugazzola L, et al. Routine measurement of serum calcitonin in nodular thyroid disease allows the preoperative diagnosis of unsuspected sporadic medullary thyroid carcinoma. J Clin Endocrinol Metab. 1994;78:826–829.

    Article  PubMed  CAS  Google Scholar 

  11. Cheung K, Roman SA, Wang TS, et al. Calcitonin measurement in the evaluation of thyroid nodules in the United States: a cost effectiveness and discussion analysis. J Clin Endocrinol Metab. 2008;93:2173–2218.

    Article  PubMed  CAS  Google Scholar 

  12. Thurston V, Williams ED. Experimental induction of C-cell tumours in thyroid by increased dietary content of vitamin D3. Acta Endocrinol. 1982;100:41–45.

    PubMed  CAS  Google Scholar 

  13. Triggs SM, Williams ED. Experimental carcinogenesis in the rat thyroid follicular and C-cells. A comparison of the effect of variation in dietary calcium and of radiation. Acta Endocrinol. 1977;858:4–92.

    Google Scholar 

  14. DeLellis RA. Multiple endocrine neoplasia syndromes revisited. Clinical, morphological and molecular features. Lab Invest. 1995;72:494–505.

    PubMed  CAS  Google Scholar 

  15. Lips CMJ, Vasen HFA, Lamers CBHW. Multiple endocrine neoplasia syndromes. CRC Crit Rev Oncol Hematol. 1988;2:117–184.

    Article  Google Scholar 

  16. Gimm O, Morrison CD, Suster S, et al. Multiple endocrine neoplasia type 2. In: DeLellis RA, Lloyd RV, Heitz PU, Eng C, eds. Pathology and Genetics of Tumours of Endocrine Organs. WHO Classification of Tumours. Lyon: IARC Press; 2004:211–217.

    Google Scholar 

  17. Kebebew E, Ituarte PHG, Siperstein AE, et al. Medullary thyroid carcinoma. Clinical characteristics; treatment, prognostic factors and a comparison of staging systems. Cancer. 2000;88:1139–1148.

    Article  PubMed  CAS  Google Scholar 

  18. Barbosa SL-S, Rodien P, Leboulleux S, et al. Ectopic adrenocorticotropic hormone-syndrome in medullary carcinoma of the thyroid: a retrospective analysis and review of the literature. Thyroid. 2005;15:618–623.

    Article  PubMed  Google Scholar 

  19. Gagel RF, Tashjian AH Jr, Cummings T, et al. The clinical outcome of prospective screening for multiple endocrine neoplasia type 2a: an 18 year experience. N Engl J Med. 1988;318:478–484.

    Article  PubMed  CAS  Google Scholar 

  20. Verga U, Fugazzola L, Cambiaghi S, et al. Frequent association between MEN2A and cutaneous lichen amyloidosis. Clin Endocrinol (Oxf). 2005;59:156–161.

    Article  Google Scholar 

  21. Verdy M, Weber AM, Roy CC, et al. Hirschsprung’s disease in a family with multiple endocrine neoplasia type 2. J Pediatr Gastroenterol Nutr. 1982;1:603–607.

    Article  PubMed  CAS  Google Scholar 

  22. DeLellis RA, Wolfe HJ, Gagel RF, et al. Adrenal medullary hyperplasia a morphometric analysis in patients with familial medullary thyroid carcinoma. Am J Pathol. 1976;183:177–196.

    Google Scholar 

  23. Carney JA, Sizemore GW, Tyce GM. Bilateral adrenal medullary hyperplasia in multiple endocrine neoplasia type 2: the precursor of bilateral pheochromocytoma. Mayo Clin Proc. 1975;50:3–10.

    PubMed  CAS  Google Scholar 

  24. Carney JA, Sizemore GW, Hayles AB. Multiple endocrine neoplasia type 2B. Pathobiol Annu. 1978;8:105–153.

    PubMed  CAS  Google Scholar 

  25. Leboulleux S, Travagli JP, Caillou B, et al. Medullary thyroid carcinoma as part of a multiple endocrine neoplasia type 2B syndrome. Influence of the stage on the clinical course. Cancer. 2002;94:44–50.

    Article  PubMed  CAS  Google Scholar 

  26. Farndon JR, Leight GS, Dilley WG, et al. Familial medullary thyroid carcinoma without associated endocrinopathies: a distinct clinical entity. Br J Surg. 1986;73(4):278–281.

    Article  PubMed  CAS  Google Scholar 

  27. Elisei R, Romei C, Cosci B, et al. RET genetic screening in patients with medullary thyroid cancer and their relatives: experience with 807 individuals at one center. J Clin Endocrinol Metab. 2007;92:4725–4729.

    Article  PubMed  CAS  Google Scholar 

  28. Mizukami Y, Kurumaya H, Nonomura A, et al. Sporadic medullary microcarcinoma of the thyroid. Histopathology. 1992;21:373–377.

    Article  Google Scholar 

  29. Zaatari GS, Saigo PC, Huvos AG. Mucin production in medullary carcinoma of the thyroid. Arch Pathol Lab Med. 1983;107:70–74.

    PubMed  CAS  Google Scholar 

  30. Sletton K, Westermark P, Natwig JB. Characterization of amyloid fibril proteins from medullary carcinoma of the thyroid. J Exp Med. 1976;143:993–998.

    Article  Google Scholar 

  31. Khurana R, Agarwal A, Bajpai VK, et al. Unraveling the amyloid associated with human medullary carcinoma. Endocrinology. 2004;154:5465–5470.

    Article  CAS  Google Scholar 

  32. Kini S. Thyroid Cytopathology: An Atlas and Text. Philadelphia: Lippencott Williams and Wilkins; 2008.

    Google Scholar 

  33. Kaufmann O, Dietel M. Expression of thyroid transcription factor-1 in pulmonary and extrapulmonary small cell carcinomas and other neuroendocrine carcinomas of various primary sites. Histopathology. 2000;36:415–420.

    Article  PubMed  CAS  Google Scholar 

  34. Bejarano PA, Nikiforov YE, Swenson ES, Biddinger PW. Thyroid transcription factor-1, thyroglobulin, cytokeratin 7 and cytokeratin 20 in thyroid neoplasms. Appl Immunohistochem Mol Morphol. 2000;8:189–194.

    Article  PubMed  CAS  Google Scholar 

  35. Kimura N, Nakazato Y, Nagura H, Sasano N. Expression of intermediate filaments in neuroendocrine tumors. Arch Pathol Lab Med. 1990;114:506–510.

    PubMed  CAS  Google Scholar 

  36. DeLellis RA. The pathology of medullary thyroid carcinoma and its precursors. In: LiVolsi VA, DeLellis RA, eds. Pathology of the Parathyroid and Thyroid Glands. Baltimore: Williams and Wilkins; 1993:77–102.

    Google Scholar 

  37. Holm R, Sobrinho-Simoes M, Fould NJM, VE JJV. Medullary carcinoma of the thyroid gland: and immunocytochemical study. Ultrastruct Pathol. 1985;8:25–41.

    Article  PubMed  CAS  Google Scholar 

  38. Portela-Gomes GM, Luckinius GM, Grimeluis L. synaptic vesicle protein 2, a new neuroendocrine cell marker. Am J Pathol. 2000;157:1299–1309.

    PubMed  CAS  Google Scholar 

  39. Schmid KW, Fisher-Colbrie R, Hagn C, Jasani B, Williams E, Winkler H. Chromogranin A and B and secretogranin II in medullary carcinomas of the thyroid. Am J Surg Pathol. 1987;11:551–556.

    Article  PubMed  CAS  Google Scholar 

  40. Katsetos CD, Jami MM, Krishna L, Jackson R, Patchefsky AS, Cooper HS. Novel immunohistochemical localization of 28, 000 molecular weight (Mr) calcium binding protein (Calbindin-D28k) in enterochromaffin cells of the human appendix and neuroendocrine tumors (carcinoids and small cell carcinomas) of the midgut and foregut. Arch Pathol Lab Med. 1994;11:633–639.

    Google Scholar 

  41. Komminoth P, Roth J, Saremaslani P, Matias-Guiu T, Wolfe HF, Heitz PU. Polysialic acid of the neural cell adhesion molecule in the human thyroid: a marker for medullary thyroid carcinoma and primary C-cell hyperplasia. An immumohistochemical study of 70 thyroid lesions. Am J Surg Pathol. 1994;18:399–411.

    Article  PubMed  CAS  Google Scholar 

  42. Saad MF, Ordonez NG, Guido JJ, Samaan N. The prognostic value of calcitonin immunostaining in medullary carcinoma of the thyroid. J Clin Endocrinol Metab. 1984;59:850–856.

    Article  PubMed  CAS  Google Scholar 

  43. Sikri KL, Varndell IM, Hamid QA, et al. Medullary carcinoma of the thyroid. An immunocytochemical and histochemical study of 25 cases using 8 separate markers. Cancer. 1985;56:2481–2491.

    Article  PubMed  CAS  Google Scholar 

  44. Steenbergh PH, Heppner JW, Zandberg J, et al. Calcitonin gene related peptide coding sequence is conserved in the human genome and is expressed in medullary thyroid carcinoma. J Clin Endocrinol Metab. 1984;5:358–360.

    Article  Google Scholar 

  45. Zajac JD, Penschow J, Mason T, et al. Identification of calcitonin and calcitonin gene-related peptide messenger RNA in medullary thyroid carcinoma by hybridization histochemistry. J Clin Endocrinol Metab. 1986;62:1037–1043.

    Article  PubMed  CAS  Google Scholar 

  46. Scopsi L, Ferrari C, Pilotti S, et al. Immunocytochemical localization and identification of prosomatostatin gene products in medullary carcinoma of human thyroid gland. Hum Pathol. 1990;21:820–830.

    Article  PubMed  CAS  Google Scholar 

  47. Sunday ME, Wolfe HJ, Roos BA, Chin WW, Spindel ER. Gastrin releasing peptide gene expression in developing, hyperplastic and neoplastic thyroid C-cell. Endocrinology. 1988;122:1551–1558.

    Article  PubMed  CAS  Google Scholar 

  48. Williams ED, Morales AM, Horn RC. Thyroid carcinoma and Cushing’s syndrome. A report of two cases with review of the common features of the non-endocrine tumours associated with Cushing’s syndrome. J Clin Pathol. 1968;21:129–135.

    Article  PubMed  CAS  Google Scholar 

  49. Roth KA, Bensch KG, Hoffman AR. Characterization of opioid peptides in human thyroid medullary carcinoma. Cancer. 1987;59:850–856.

    Article  Google Scholar 

  50. Birkenhäger JC, Upton GV, Seldenrath HJ, Krieger DT, Tashjian AH Jr. Medullary thyroid carcinoma: ectoic production of peptides with ACTH-like, corticotropin-releasing factor-like and prolactin production - stimulating activities. Acta Endocrinol (Copenh). 1976;83:280–292.

    Google Scholar 

  51. Uribe M, Fenoglio-Preiser CN, Grimes M, Feind C. Medullary carcinoma of the thyroid gland. Clinical, pathological, and immunohistochemical features with review of the literature. Am J Surg Pathol. 1985;9:577–594.

    Article  PubMed  CAS  Google Scholar 

  52. Faggiano A, Talbot M, Lacroix L, et al. Differential expression of galectin-3 in medullary thyroid carcinoma and C-cell hyperplasia. Clin Endocrinol. 2002;57:813–819.

    Article  CAS  Google Scholar 

  53. DeLellis RA, Rule AH, Spiler I, Nathanson L, Tashjian AH Jr, Wolfe HJ. Calcitonin and carcinoembryonic antigen as tumor markers in medullary thyroid carcinoma. Am J Clin Pathol. 1978;70:587–594.

    PubMed  CAS  Google Scholar 

  54. Schroder S, Klöppel G. Carcinoembryonic antigen and non-specific cross-reacting antigen in thyroid cancer. An immunocytochemical study using polyclonal and monoclonal antibodies. Am J Surg Pathol. 1987;11:100–108.

    Article  PubMed  CAS  Google Scholar 

  55. Mendelsohn G, Wells SA, Baylin SB. Relationship of tissue carcinoembryonic antigen and calcitonin to tumor virulence in medul­lary thyroid carcinoma. An immunohistochemical study in early, localized and virulent disseminated stages of disease. Cancer. 1984;54:657–662.

    Article  PubMed  CAS  Google Scholar 

  56. Kakudo K, Miyauchi A, Yakai SI, et al. C-cell carcinoma of the thyroid, papillary type. Acta Pathol Jpn. 1979;29:653–659.

    PubMed  CAS  Google Scholar 

  57. Harach HR, Williams ED. Glandular (tubular and follicular) variants of medullary carcinoma of the thyroid. Histopathology. 1983;7:83–97.

    Article  PubMed  CAS  Google Scholar 

  58. Harach HR, Bergholm U. Small cell variant of medullary carcinoma of the thyroid with neuroblastoma-like features. Histopathology. 1992;21:378–380.

    Article  PubMed  CAS  Google Scholar 

  59. Eusebi V, Damiani S, Riva C, Lloyd RV, Capella C. Calcitonin free oat cell carcinoma of the thyroid gland. Virchows Arch A Pathol Anat Histopathol. 1990;417:267–271.

    Article  PubMed  CAS  Google Scholar 

  60. Mendelsohn G, Baylin SB, Bigner SH, et al. Anaplastic variants of medullary thyroid carcinoma: a light microscopic and immunohistochemical study. Am J Surg Pathol. 1980;4:333–341.

    Article  PubMed  CAS  Google Scholar 

  61. Landon G, Ordóñex NG. Clear cell variant of medullary carcinoma of the thyroid. Hum Pathol. 1985;16:844–847.

    Article  PubMed  CAS  Google Scholar 

  62. Marcus JN, Dise CA, LiVolsi VA. Melanin production in a medullary thyroid carcinoma. Cancer. 1982;49:2518–2526.

    Article  PubMed  CAS  Google Scholar 

  63. Beerman H, Rigaud C, Bogomeletz WV, Hollander H, Veldhuizen H. Melanin production in black medullary thyroid cancer (MTC). Histopathology. 1990;16:227–234.

    Article  PubMed  CAS  Google Scholar 

  64. Dominguez-Malagon H, Delgardo-Chavez R, Torres-Najera M, Gould E, Albores-Saavedra J. Oxyphil and squamous variants of medullary thyroid carcinoma. Cancer. 1989;63:1183–1188.

    Article  PubMed  CAS  Google Scholar 

  65. Golough R, Us-Krasovec M, Auersperg M, Jancar J, Bondi A, Eusebi V. Amphicrine-composite calcitonin and mucin producing carcinoma of the thyroid. Ultrastruct Pathol. 1985;8:197–206.

    Article  Google Scholar 

  66. Huss LJ, Mendlesohn G. Medullary carcinoma of the thyroid gland: an encapsulated variant resembling the hyalinizing trabecular (paraganglioma-like) adenoma of thyroid. Mod Pathol. 1990;3:581–585.

    PubMed  CAS  Google Scholar 

  67. Laforga JB, Aranda FI. Pseudoangiosarcomatous features in medullary thyroid carcinoma spindle cell variant. Report of a case studied by FNA and immunohistochemistry. Diagn Cytopathol. 2007;34:424–428.

    Article  Google Scholar 

  68. Beskid M, Lorenc R, Rôsciszewska A. C-cell thyroid adenoma in man. J Pathol. 1971;103:3343–3346.

    Article  Google Scholar 

  69. Kodama T, Okamoto T, Fujjimoto Y, et al. C-cell adenoma in the thyroid: a rare but distinct clinical entity. Surgery. 1988;104:997–1003.

    PubMed  CAS  Google Scholar 

  70. Mendelsohn G, Oertel JE. Encapsulated medullary thyroid carcinoma [Abstract]. Lab Invest. 1981;44:43A.

    Google Scholar 

  71. Matias-Guiu X, LaGuette J, Puras-Gil AM, Rosai J. Metastatic neuroendocrine tumors to the thyroid mimicking medullary carcinoma: a pathological and immunohistochemical study of six cases. Am J Surg Pathol. 1997;21:754–762.

    Article  PubMed  CAS  Google Scholar 

  72. Shikama Y, Osawa T, Yagihashis N, et al. Neuroendocrine differentiation in hyalinizing trabecular tumors of the thyroid. Virchows Arch. 2003;443:792–796.

    Article  PubMed  CAS  Google Scholar 

  73. Wolfe HJ, Melvin KE, Cervi-Skinner SJ, et al. C-cell hyperplasia preceding medullary thyroid carcinoma. N Engl J Med. 1973;289:437–441.

    Article  PubMed  CAS  Google Scholar 

  74. Wells SA, Ontjes DA, Cooper CW, et al. The early diagnosis of medullary carcinoma of the thyroid gland in patients with multiple endocrine neoplasia type II. Ann Surg. 1975;182:362–370.

    Article  PubMed  Google Scholar 

  75. DeLellis RA, Nunnemacher G, Wolfe HJ. C-cell hyperplasia: an ultrastructural analysis. Lab Invest. 1977;36:237–248.

    PubMed  CAS  Google Scholar 

  76. McDermott MB, Swanson PE, Wick MR. Immunostains for collagen type IV discriminate between C-cell hyperplasia and microscopic medullary carcinoma in multiple endocrine neoplasia, type 2A. Hum Pathol. 1995;26:1308–1312.

    Article  PubMed  CAS  Google Scholar 

  77. Albores-Saavedra J, Monforte H, Nadji M, Morales AR. C-cell hyperplasia in thyroid tissue adjacent to follicular cell tumors. Hum Pathol. 1988;19:795–799.

    Article  PubMed  CAS  Google Scholar 

  78. Guyetant S, Rousselet MC, Durigon M, et al. Sex related C-cell hyperplasia in the normal human thyroid: a quantitative autopsy study. J Clin Endocrinol Metab. 1997;82:42–47.

    Article  PubMed  CAS  Google Scholar 

  79. Perry A, Molberg K, Albores-Saavedra J. Physiologic versus neoplastic C-cell hyperplasia of the thyroid: separation of distinct histologic and biologic entities. Cancer. 1996;77:750–756.

    Article  PubMed  CAS  Google Scholar 

  80. Carney JA, Sizemore GW, Hales AB. Multiple endocrine neoplasia, type 2B. Pathobiol Annu. 1978;8:105–153.

    PubMed  CAS  Google Scholar 

  81. Diaz-Cano S, DeMiguel M, Blanes A, et al. Germline RET634 mutation positive MEN2A related C-cell hyperplasias have genetic features consistent with intraepithelial neoplasias. J Clin Endocrinol Metab. 2001;86:3948–3951.

    Article  PubMed  CAS  Google Scholar 

  82. Kaserer K, Scheuba C, Neuhold N, et al. C-cell hyperplasia and medullary thyroid carcinoma in patients routinely screened for serum calcitonin. Am J Surg Pathol. 1998;22:722–728.

    Article  PubMed  CAS  Google Scholar 

  83. Kaserer K, Scheuba C, Neuhold N, et al. sporadic versus familial medullary thyroid microcarcinoma: a histopathologic study of 50 consecutive patients. Am J Surg Pathol. 2001;25:1245–1251.

    Article  PubMed  CAS  Google Scholar 

  84. Mears L, Diaz-Cano S. Difference between familial and sporadic medullary thyroid carcinomas (Letter). Am J Surg Pathol. 2003;27:266–267.

    Article  PubMed  Google Scholar 

  85. Mathew CG, Chin KS, Easton DF, et al. A linked genetic marker for multiple endocrine neoplasia type 2A on chromosome 10. Nature. 1987;328:527–528.

    Article  PubMed  CAS  Google Scholar 

  86. Simpson NE, Kidd KK, Goodfellow PJ, et al. Assignment of multiple endocrine neoplasia type 2A to chromosome 10 by linkage. Nature. 1987;328:528–530.

    Article  PubMed  CAS  Google Scholar 

  87. Ponder BA, Coffe R, Gagel RF, et al. Risk estimation and screening of families of patients with medullary thyroid carcinoma. Lancet. 1988;1:397–401.

    Article  PubMed  CAS  Google Scholar 

  88. Sobol H, Narod SA, Nakamura Y, et al. Screening for multiple endocrine neoplasia type 2A with DNA polymorphism analysis. N Engl J Med. 1989;321:996–1001.

    Article  PubMed  CAS  Google Scholar 

  89. Gardner E, Papi L, Easton DF, et al. Genetic linkage studies map the multiple endocrine neoplasia type 2 loci to a small interval of chromosome 10q 11.2. Hum Mol Genet. 1993;2:241–246.

    Article  PubMed  CAS  Google Scholar 

  90. Lairmore TC, Dou S, Howe JR, et al. A1.5 megabase yeast artificial chromosome contig from human chromosome 10q 11.2 connecting 3 genetic loci (RET, D10S94, and D10S102) closely linked to the MEN2A locus. Proc Natl Acad Sci USA. 1993;90:492–496.

    Article  PubMed  CAS  Google Scholar 

  91. Mole SE, Mulligan LM, Healey CS, et al. Localization of the gene for localization of the gene for multiple endocrine neoplasia type 2A to a 480 kb region in chromosome band 10q 11.2. Hum Mol Genet. 1993;2:247–252.

    Article  PubMed  CAS  Google Scholar 

  92. Mulligan LM, Kwok JBJ, Healey CS, et al. Germline mutations of the RET proto-oncogene in multiple endocrine neoplasia type 2A. Nature. 1993;363:458–460.

    Article  PubMed  CAS  Google Scholar 

  93. Donis-Keller H, Dou S, Chi D, et al. Mutations in the RET proto-oncogene are associated with MEN2A and FMTC. Hum Mol Genet. 1993;2:851–856.

    Article  PubMed  CAS  Google Scholar 

  94. Mulligan LM, Eng C, Healey CS, et al. Specific mutations of the RET proto-oncogene are related to disease phenotype in MEN2A and FMTC. Nat Genet. 1994;6:70–74.

    Article  PubMed  CAS  Google Scholar 

  95. Hofstra RM, Landsvater RM, Ceccherini I, et al. A mutation in the RET proto-oncogene associated with multiple endocrine neoplasia type 2B and sporadic medullary thyroid carcinoma. Nature. 1994;367:375–376.

    Article  PubMed  CAS  Google Scholar 

  96. Eng C, Smith DP, Mulligan LM, et al. Point mutations within the tyrosine kinase domain of the RET proto-oncogene in multiple endocrine neoplasia type 2B and related sporadic tumors. Hum Mol Genet. 1994;3:237–241.

    Article  PubMed  CAS  Google Scholar 

  97. Carlson KM, Dou S, Chi D, et al. single missense mutation in the tyrosine kinase catalytic domain of the RET proto-oncogene is associated with multiple endocrine neoplasia type 2B. Proc Natl Acad Sci USA. 1994;91:1579–1583.

    Article  PubMed  CAS  Google Scholar 

  98. Eng C, Clayton D, Schuffenecker I, et al. The relationship between specific RET proto-oncogene mutations and disease phenotype in multiple endocrine neoplasia type 2. International RET mutation consortium analysis. JAMA. 1996;276:1575–1579.

    Article  PubMed  CAS  Google Scholar 

  99. Eng C. RET proto-oncogene in the development of human cancer. J Clin Oncol. 1999;17:380–393.

    PubMed  CAS  Google Scholar 

  100. Hoff AO, Cote GJ, Gagel RF. Multiple endocrine neoplasias. Annu Rev Physiol. 2000;62:377–411.

    Article  PubMed  CAS  Google Scholar 

  101. Takahashi M, Ritz J, Cooper GM. Activation of a novel human transforming gener, ret by DNA rearrangement. Cell. 1985;42:581–588.

    Article  PubMed  CAS  Google Scholar 

  102. Takahashi M, Buma Y, Iwamoto T. Cloning and expression of the ret proto-oncogene encoding a tyrosine kinase with two potential transmembrane domains. Oncogene. 1988;3:571–578.

    PubMed  CAS  Google Scholar 

  103. Grieco M, Santoro M, Berlingiere MT, et al. PTC is a novel rearranged form of the ret proto-oncogene and is frequently detected in vivo in human papillary carcinomas. Cell. 1990;60:557–563.

    Article  PubMed  CAS  Google Scholar 

  104. Santoro M, Dathan NA, Berlingieri MT, et al. Molecular characterization of RET/PTC3, a novel rearranged version of the RET proto-oncogene n a human papillary thyroid carcinoma. Oncogene. 1990;9:509–516.

    Google Scholar 

  105. Klugbauer S, Demidchik EP, Lengfelder E, Rabes HM. Detection of a novel type of RET rearrangement (PTC5) in thyroid carcinomas after Chernobyl and analysis of the involved RET-fused gene RFG5. Cancer Res. 1998;58:198–203.

    PubMed  CAS  Google Scholar 

  106. LiVolsi VA, Albores-Saavedra J, Asa SL, et al. Papillary carcinoma. In: DeLellis RA, Lloyd RV, Heitz PU, Eng C, eds. WHO Classification of Tumours. Lyon: IARC Press; 2004:57–66.

    Google Scholar 

  107. Lam AKY, Montore KT, Nolan KA, LiVolsi VA. RET oncogene acti­vation in papillary thyroid carcinoma: Prevalence and implication of the histological parameters. Hum Pathol. 1998;19:565–568.

    Article  Google Scholar 

  108. Jhiang SM, Sagartz JE, Tong Q, et al. Targeted expression of the ret/PTC1 oncogene induces papillary thyroid carcinomas. Endocrinology. 1996;137:375–378.

    Article  PubMed  CAS  Google Scholar 

  109. Fischer AH, Bond JA, Taysavang P, Battles OE, Wynford-Thomas D. Papillary thyroid carcinoma oncogene (RET/PTC) alters the nuclear envelope and chromatin structure. Am J Pathol. 1998;153:1443–1450.

    PubMed  CAS  Google Scholar 

  110. Nagao M, Ishizaka Y, Nakagawora A, et al. expression of ret proto-oncogene in human in neuroblastomas. Jpn J Cancer Res. 1990;81:309–312.

    PubMed  CAS  Google Scholar 

  111. Santoro M, Rosati R, Grieco M, et al. The ret- proto-oncogene is consistently expressed in human pheochromocytomas and thyroid medullary carcinomas. Oncogene. 1990;5:1595–1598.

    PubMed  CAS  Google Scholar 

  112. Pasini B, Hofstra RM, Yin L, et al. The physical map of the RET proto-oncogene. Oncogene. 1995;11:1737–1743.

    PubMed  CAS  Google Scholar 

  113. Pachnis V, Mankoo B, Costantiri F. Expression of the C-ret proto-oncogene during mouse embryogenesis. Development. 1993;119:1005–1017.

    PubMed  CAS  Google Scholar 

  114. Schuchardt A, D’Agati V, Larsson-Bloomberg L, Costantini F, Pachnis V. Defects in the kidney and enteric nervous system of mice lacking the tyrosine kinase receptor ret. Nature. 1994;367:380–383.

    Article  PubMed  CAS  Google Scholar 

  115. Durbee P, Marcos-Guiterrez CV, Kilkenny C, et al. Glial cell line derived neurotrophic factor signaling through the RET receptor tyrosine kinase. Nature. 1996;381:789–793.

    Article  Google Scholar 

  116. Jing S, Wen D, Yu Y, et al. GDNF-induced activation of the ret protein tyrosine kinase is mediated by GDNFR-δ, a novel receptor for GDNF. Cell. 1996;85:1113–11124.

    Article  PubMed  CAS  Google Scholar 

  117. Treanor JJ, Goodman L, deSauvage F, et al. Characterization of a multicomponent receptor. Nature. 1996;381:80–83.

    Article  Google Scholar 

  118. Sanicola M, Hession C, Worlely D, et al. GDNF-dependent RET activation can be mediated by two different cell surface accessory proteins. Proc Natl Acad Sci USA. 1997;94:6238–6243.

    Article  PubMed  CAS  Google Scholar 

  119. Kotzbauer PT, Lampe PA, Heuckeroth RO, et al. Neurtusin, a relative of glial cell line derived neurotropic factor. Nature. 1996;384:467–470.

    Article  PubMed  CAS  Google Scholar 

  120. Jing S, Yu Y, Fang M, et al. GFR-alpha-2 and GFR-alpha 3 are two new receptors for ligands of the GDNF family. J Biol Chem. 1997;272:33111–33117.

    Article  PubMed  CAS  Google Scholar 

  121. Baloh RH, Tansey MG, Lampe PA, et al. Artemin, a novel member of GDNF ligand family, supports peripheral and central neurons and signals through the GFR alpha 3-RET receptor complex. Neuron. 1998;21:1291–1302.

    Article  PubMed  CAS  Google Scholar 

  122. Lai AZ, Gujral TS, Mulligan LM. RET signalling in endocrine tumors: delving deeper into molecular mechanisms. Endocr Pathol. 2007;18:57–67.

    Article  PubMed  CAS  Google Scholar 

  123. Santoro M, Carlomagno F, Romano A, et al. Activation of RET as a dominant transforming by germline mutations of MEN2A and MEN2B. Science. 1995;267:381–383.

    Article  PubMed  CAS  Google Scholar 

  124. Iwashita T, Asai N, Murakami H, et al. Identification of tyrosine residues that are essential for transforming activity of the ret proto-oncogene with MEN2A or MEN2B mutations. Oncogene. 1976;12:481–487.

    Google Scholar 

  125. Gimm O, Marsh DJ, Andrew SD, et al. Germline dinucleotide mutation in codon 883 of the RET proto-oncogene in multiple endocrine neoplasia type 2B without codon 918 mutation. J Clin Endocrinol Metab. 1997;81:3902–3904.

    Article  Google Scholar 

  126. Smith DP, Houghton C, Ponder BA. Germline mutation of RET codon 883 in two cases of de novo MEN2B. Oncogene. 1997;15:1213–1217.

    Article  PubMed  CAS  Google Scholar 

  127. Kawai K, Iwashita T, Murakami H, et al. Tissue specific carcinogenesis in neoplasia type 2A mutation. Cancer Res. 2000;60:5254–5260.

    PubMed  CAS  Google Scholar 

  128. Marsh DJ, Zheng Z, Arnold A, et al. Mutation analysis of glial cell line derived neurotropic factor, a ligand for the RET/co-receptor complex in MEN2 and sporadic neuroendocrine tumors. J Clin Endocrinol Metab. 1997;81:3025–3028.

    Article  Google Scholar 

  129. Peacock ML, Borst MJ, Sweet JD, Decker RA. Detection of RET mutations in multiple endocrine neoplasia type 2A and familial medullary thyroid carcinoma by denaturing gel electrophoresis. Hum Mutat. 1996;7:100–104.

    Article  PubMed  CAS  Google Scholar 

  130. Wohllk N, Cote GJ, Evans DB, et al. Application of genetic screening information to the management of medullary thyroid carcinoma and multiple endocrine neoplasia type 2. Endocrinol Metab Clinics North Am. 1996;25:1–25.

    Article  CAS  Google Scholar 

  131. Wells SA, Chi DD, Toshima K, et al. Predictive DNA testing and prophylactic thyroidectomy in patients at risk for multiple endocrine neoplasia type 2A. Ann Surg. 1994;220:237–250.

    Article  PubMed  Google Scholar 

  132. Lips CJ, Landsvater RM, Hoppener JW, et al. Clinical screening as compared with DNA analysis in families with multiple endocrine neoplasia type 2A. N Engl J Med. 1994;331:828–835.

    Article  PubMed  CAS  Google Scholar 

  133. Dralle H, Gimm O, Simon D, et al. Prophylactic thyroidectomy in 75 children and adolescents with hereditary mudullary thyroid carcinoma: German and Austrian experience. World J Surg. 1998;22(7):744–751.

    Article  PubMed  CAS  Google Scholar 

  134. Offit K, Biesecker BB, Burt RW, et al. Statement of the American Society of Oncology: genetic testing for cancer susceptibility. J Clin Oncol. 1996;14:1730–1736.

    Google Scholar 

  135. Wohllk N, Cote GJ, Bugalho MM, et al. Relevance of RET proto-oncogene mutations in sporadic medullary thyroid carcinoma. J Clin Endocrinol Metab. 1996;81:3740–3745.

    Article  PubMed  CAS  Google Scholar 

  136. Zedenius J, Wallin G, Hamberger B, et al. Somatic and MEN2A de novo mutations identified in the RET proto-oncogene by screening of sporadic MTCs. Hum Mol Genet. 1994;3:1259–1262.

    Article  PubMed  CAS  Google Scholar 

  137. Eng C, Mulligan LM, Healey CS, et al. Heterogeneous mutation of the RET proto-oncogene in subpopulations of medullary thyroid carcinoma. Cancer Res. 1996;56:2167–2170.

    PubMed  CAS  Google Scholar 

  138. Marsh DJ, Learoyd DL, Andrew SD, et al. Somatic mutations in the RET proto-oncogene in sporadic medullary thyroid carcinoma. Clin Endocrinol. 1996;44:249–257.

    Article  CAS  Google Scholar 

  139. Saggiorato E, Rapa I, Garino F, et al. Absence of RET gene point mutation in sporadic C-cell hyperplasia. J Mol Diagn. 2007;9:214–219.

    Article  PubMed  CAS  Google Scholar 

  140. Eng C, Crossey PA, Mulligan LM, et al. Mutations of the RET proto-oncogene and von Hippel Lindau disease tumour suppressor gene in sporadic and syndromic pheochromocytoma. J Med Genet. 1995;32:934–937.

    Article  PubMed  CAS  Google Scholar 

  141. Lindor LM, Honchel R, Khosla S, et al. Mutations in the RET proto-oncogene in sporadic pheochromocytomas. J Clin Endocrinol Metab. 1995;80:627–629.

    Article  PubMed  CAS  Google Scholar 

  142. Beldjord B, Desclaux-Arranond F, Raffin-Samson M, et al. The RET proto-oncogene in sporadic pheochromocytomas. Frequent MEN2-like mutations and new molecular defects. J Clin Endocrinol Metab. 1995;80:2063–2068.

    Article  PubMed  CAS  Google Scholar 

  143. Padberg BC, Schroder S, Jochum W, et al. Absence of RET proto-oncogene point mutations in sporadic hyperplastic and neoplastic lesions of the parathyroid gland. Am J Pathol. 1995;147:1600–1607.

    PubMed  CAS  Google Scholar 

  144. Komminoth P, Roth J, Mulletta-Feurer S, et al. RET proto-oncogene point mutations in sporadic neuroendocrine tumors. J Clin Endocrinol Metab. 1996;81:2041–2046.

    Article  PubMed  CAS  Google Scholar 

  145. Eng C, Mulligan LM. Mutations of the RET proto-oncogene in the multiple endocrine neoplasia type 2 syndrome, related sporadic tumours and Hirschsprung disease. Hum Mut. 1997;9:97–109.

    Article  PubMed  CAS  Google Scholar 

  146. Fialkowski EA, Moley JF. Current approaches to medullary thyroid carcinoma, sporadic and familial. J Surg Oncol. 2006;94:737–747.

    Article  PubMed  CAS  Google Scholar 

  147. Moley JF, Fialkowski EA. Evidence based approach to the managementof sporadic medullary thyroid carcinoma. World J Surg. 2007;31:946–956.

    Article  PubMed  Google Scholar 

  148. Ball DW. Medullary thyroid carcinoma: therapeutic targets and molecular markers. Curr Opin Oncol. 2007;19:18–23.

    Article  PubMed  CAS  Google Scholar 

  149. Modigliani E, Cohen R, Campos JM, et al. Prognostic factors for survival and for biochemical cure in medullary thyroid carcinoma: results in 819 patients. The GETC Study Group. Groupe d’etude des tumeurs a calcitonine. Clin Endocrinol (Oxf). 1998;48:265–273.

    Article  CAS  Google Scholar 

  150. Vezzosi D, Bennet A, Caron P. Recent advances in treatment of medullary thyroid carcinoma. Ann Endocrinol (Paris). 2007;68:147–153.

    CAS  Google Scholar 

  151. Schröder S, Böcker W, Baisch H, et al. Prognostic factors in medullary thyroid carcinoma. Survival in relation to age, sex, stage, histology, immunohistochemistry and DNA content. Cancer. 1998;61:806–816.

    Article  Google Scholar 

  152. Koporek O, Scheuba C, Cherenko M, et al. Desmoplasia in medullary thyroid carcinoma: a reliable indicator of metastatic potential. Histopathology. 2008;52:623–630.

    Article  Google Scholar 

  153. Barbet J, Campion L, Kraeber-Bodere F, Chatal JF. Prognostic impact of serum calcitonin and carcinoembryonic antigen doubling times in patients with medullary thyroid carcinoma. J Clin Endocrinol Metab. 2005;90:6077–6084.

    Article  PubMed  CAS  Google Scholar 

  154. Elisei R, Cosci B, Romei C, et al. Prognostic significance of somatic RET oncogene mutations in sporadic medullary thyroid carcinoma: a 10-year follow-up study. J Clin Endocrinol Metab. 2008;93:682–687.

    Article  PubMed  CAS  Google Scholar 

  155. Hales M, Rosenau W, Okerlund MD, Galante M. Carcinoma of the thyroid with a mixed medullary and follicular pattern: morphological, immunohistochemical and clinical laboratory studies. Cancer. 1982;50:1352–1359.

    Article  PubMed  CAS  Google Scholar 

  156. Pfaltz M, Hedinger CE, Muhlethales JP. Mixed medullary and follicular carcinoma of the thyroid. Virchows Arch [Pathol Anat]. 1983;400:53–59.

    Article  CAS  Google Scholar 

  157. Ljungberg O, Ericsson U-B, Bondeson L, Thorell J. A compound follicular-parafollicular cell carcinoma of the thyroid: a new tumor entity? Cancer. 1984;52:1053–1061.

    Article  Google Scholar 

  158. Ljungberg OB, Bondeson L, Bondeson AG. Differentiated thyroid carcinoma, intermediate type: a new tumor entity with features of follicular and parafollicular cell carcinoma. Hum Pathol. 1984;15:218–228.

    Article  PubMed  CAS  Google Scholar 

  159. Holm R, Sobrinho-Simoes M, Nesland JM, Sambade C, Johannessen JV. Medullary thyroid carcinoma with thyroglo­bulin immunoreactivity. A special entity? Lab Invest. 1987;57:258–268.

    PubMed  CAS  Google Scholar 

  160. LiVolsi VA. Mixed thyroid carcinoma: a real entity? Lab Invest. 1987;57:237–239.

    PubMed  CAS  Google Scholar 

  161. Albores-Saavedra J, de la Mora TG, de la Torra-Rendon F, Gould E. Mixed medullary-papillary carcinoma of the thyroid: a previously unrecognized variant of thyroid carcinoma. Hum Pathol. 1990;21:1151–1155.

    Article  PubMed  CAS  Google Scholar 

  162. Mizukami Y, Michigishi T, Nonomura A, et al. Mixed medullary-follicular carcinoma of the thyroid occurring in familial form. Histopathology. 1993;22:284–287.

    Article  PubMed  CAS  Google Scholar 

  163. Matias-Guiu X, Caixas A, Costa I, Cabezas R, Prat J. Compound medullary-papillary carcinoma of the thyroid: true mixed versus collision tumour. Histopathology. 1994;25:183–185.

    Article  PubMed  CAS  Google Scholar 

  164. Lax SF, Beham A, Kronberger-Schönecker D, Langsteger W, Denk H. Coexistence of papillary and medullary carcinoma of the thyroid gland-mixed or collision tumors? Clinicopathological analysis of three cases. Virchows Arch. 1994;424:441–447.

    Article  PubMed  CAS  Google Scholar 

  165. Kobayashi K, Teramoto S, Maeta H, Ishiguro S, Mori T, Horie Y. Simultaneous occurrence of medullary carcinoma and papillary carcinoma of the thyroid. J Surg Oncol. 1995;59:276–279.

    Article  PubMed  CAS  Google Scholar 

  166. Mizukami Y, Nonomura A, Michigishi T, Noguchi M, Ishizaki T. Mixed medullary-follicular carcinoma of the thyroid gland: a clinicopathologic variant of medullary thyroid carcinoma. Mod Pathol. 1996;9:631–635.

    PubMed  CAS  Google Scholar 

  167. Papotti M, Negro F, Carney JA, Bussolati G, Lloyd RV. Mixed medullary-follicular carcinoma of the thyroid. A morphological, immunohistochemical and in situ hybridization analysis of 11 cases. Virchows Arch. 1997;430:397–405.

    Article  PubMed  CAS  Google Scholar 

  168. Matias-Guiu X. Mixed medullary and follicular carcinoma of the thyroid. On the search for its histogenesis. Am J Pathol. 1999;155:1413–1418.

    PubMed  CAS  Google Scholar 

  169. Volante M, Papotti M, Roth J, et al. Mixed medullary-follicular thyroid carcinoma. Molecular evidence for a dual origin of tumor components. Am J Pathol. 1999;155:1499–1509.

    PubMed  CAS  Google Scholar 

  170. Pappoti M, Volante M, Komminoth P, Sobrinho-Simoes M, Bussolati G. Thyroid carcinomas with mixed follicular and C-cell differentiation patterns. Semin Diagn Pathol. 2000;17:109–119.

    Google Scholar 

  171. Katoh R, Jasani B, Williams ED. Hyalinizing trabecular adenomas of the thyroid: a report of three cases with immunohistochemical and ultrastructural studies. Histopathology. 1989;15:211–224.

    PubMed  CAS  Google Scholar 

  172. Carcangiu ML, Zampi G, Rosai J. Poorly differentiated (“insular”) thyroid carcinoma. A reinterpretation of Langhans “wuchernde struma”. Am J Surg Pathol. 1984;8:655–668.

    Article  PubMed  CAS  Google Scholar 

  173. Sobrinho-Simoes M. Poorly differentiated carcinomas of the thyroid. Endocr Pathol. 1996;7:99–102.

    Article  Google Scholar 

  174. Papotti M, Bussolati G, Kommoth P, et al. Mixed medullary and follicular cell carcinoma. In: DeLellis RA, Lloyd RV, Heitz PU, Eng C, eds. Pathology and Genetics of Tumours of Endocrine Organs. WHO Classification of Tumours. Lyon: IARC Press; 2004:92–92.

    Google Scholar 

  175. Mellilo RM, Cirafici AM, DeFalco V, et al. The oncogenic activity of RET point mutants for follicular thyroid cells may account for the occurrence of papillary thyroid carcinoma in patients affected by familial medullary thyroid carcinoma. Am J Pathol. 2004;165:511–521.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

DeLellis, R.A. (2010). Medullary Thyroid Carcinoma. In: Hunt, J. (eds) Molecular Pathology of Endocrine Diseases. Molecular Pathology Library, vol 3. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-1707-2_11

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-1707-2_11

  • Published:

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4419-1706-5

  • Online ISBN: 978-1-4419-1707-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics