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Controversies in Thyroid Surgery pp 157–168Cite as

Controversies in the Surgical Management of Medullary Thyroid Carcinoma

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Abstract

Medullary thyroid carcinoma (MTC) comprises approximately 5 % of all thyroid cancers. While the majority of cases are sporadic, as many as 25 % of cases are attributed to inherited mutations in the REarranged during Transfection (RET) proto-oncogene. Primary treatment is thyroidectomy and removal of involved nodal basins. Preventative thyroidectomy is recommended in at-risk RET mutation carriers. Due to the lack of randomized trials and limited widespread clinical expertise, certain aspects of treatment remain controversial. This chapter aims to elucidate the best practices based on the existing literature, the most current published guidelines, and expert surgeon recommendations. Clarification of controversial issues, including, but not limited to, age of surgery in at-risk gene carriers, extent of lymphadenectomy and parathyroid management in preventative thyroidectomy, extent of thyroidectomy and lymphadenectomy in primary and reoperations for MTC, usefulness of radiation therapy, and timing of systemic treatment, will be discussed in this chapter.

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Authors and Affiliations

  1. Department of General Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA

    Victoria M. Gershuni M.D.

  2. Department of Surgery, Barnes-Jewish Hospital, 660 S. Euclid Ave., Campus Box 8109, St. Louis, MO, 6310, USA

    Jennifer Yu M.D.

  3. Department of Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8109, St. Louis, MO, 63110, USA

    Jeffrey F. Moley M.D., F.A.C.S.

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  1. Victoria M. Gershuni M.D.
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  2. Jennifer Yu M.D.
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  3. Jeffrey F. Moley M.D., F.A.C.S.
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Correspondence to Jeffrey F. Moley M.D., F.A.C.S. .

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Editors and Affiliations

  1. Department of Surgery; University of Virginia Health System, C Bruce Morton Professor and Chief; Division of General Surgery, Charlottesville, Virginia, USA

    John B. Hanks

  2. Chairman Department of Surgery, Mount Sinai Beth Israel, Eugene W Friedman Professor of Surgery; Icahn School of Medicine at Mount Sinai, New York, New York, USA

    William B. Inabnet III

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Gershuni, V.M., Yu, J., Moley, J.F. (2016). Controversies in the Surgical Management of Medullary Thyroid Carcinoma. In: Hanks, J., Inabnet III, W. (eds) Controversies in Thyroid Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-20523-6_12

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  • DOI: https://doi.org/10.1007/978-3-319-20523-6_12

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