Medullary Thyroid Cancer

Part of the Head and Neck Cancer Clinics book series (HNCC)


Medullary thyroid cancer (MTC) is an uncommon disease, accounting for 3–10 % of all thyroid cancers worldwide [1–3]. The German literature contains reports of a thyroid malignancy with amyloid deposits as early as 1906, but it was not until 1959 when Hazard and co-workers reported on a clinicopathological, solid arrangement of cells, which represented medullary (solid) carcinoma [4, 5]. Seventy per cent of MTCs are sporadic, whereas 30 % have a germline mutation of the RET proto-oncogene, which leads to various familial forms of this disease.


National Comprehensive Cancer Network Lateral Lymph Node Medullary Thyroid Cancer Calcitonin Level Lateral Lymph Node Metastasis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Hundahl SA, Fleming ID, Fremgen AM, et al. A national cancer database report on 53,856 cases of thyroid carcinoma treated in the US, 1985–1995. Cancer. 1998;83:2638–48.PubMedGoogle Scholar
  2. 2.
    Saad MF, Ordonez NG, Rashid RK, et al. Medullary carcinoma of the thyroid. A study of the clinical features and prognostic factors in 161 patients. Medicine (Baltimore). 1984;63:319–42.Google Scholar
  3. 3.
    Aschebrook-Kilfoy B, Ward MH, Sabra MM, et al. Thyroid cancer incidence patterns in the United States by histologic type, 1992–2006. Thyroid. 2011;21:125–34.PubMedCentralPubMedGoogle Scholar
  4. 4.
    Hazard JB. The C-cells (parafollicular cells) of the thyroid gland and medullary thyroid carcinoma: a review. Am J Pathol. 1977;88:213–50.PubMedCentralPubMedGoogle Scholar
  5. 5.
    Hazard JB, Hawk WA, Crile G. Medullary (solid) carcinoma of the thyroid: a clinicopathologic entity. J Clin Endocrinol Metab. 1959;19:152–61.PubMedGoogle Scholar
  6. 6.
    Albores-Saavedra JA, Krueger JE. C-cell hyperplasia and medullary thyroid microcarcinoma. Endocr Pathol. 2001;12:365–77.PubMedGoogle Scholar
  7. 7.
    Wolfe HJ, Voelkel EF, Tashjian AH. Distribution of calcitonin-containing cells in the normal adult human thyroid gland: a correlation of morphology with peptide content. J Clin Endocrinol Metab. 1974;38:688–94.PubMedGoogle Scholar
  8. 8.
    Chen H, Sippel RS, O’Dorisio MS, et al. The North American Neuroendocrine Tumor Society consensus guideline for the diagnosis and management of neuroendocrine tumors: pheochromocytoma, paraganglioma, and medullary thyroid cancer. Pancreas. 2010;39:775–83.PubMedCentralPubMedGoogle Scholar
  9. 9.
    Machens A, Niccoli-Sire P, Hoegel J, et al. Early malignant progression of hereditary medullary thyroid cancer. N Engl J Med. 2003;349:1517–25.PubMedGoogle Scholar
  10. 10.
    Guyétant S, Dupre F, Bigorgne JC, et al. Medullary thyroid microcarcinoma: a clinicopathologic retrospective study of 38 patients with no prior familial disease. Hum Pathol. 1999;30:957–63.PubMedGoogle Scholar
  11. 11.
    Thompson LDR. Medullary thyroid carcinoma. Ear Nose Throat J. 2010;89:301–2.PubMedGoogle Scholar
  12. 12.
    Khurana R. Unraveling the amyloid associated with human medullary thyroid carcinoma. Endocrinology. 2004;145:5465–70.PubMedGoogle Scholar
  13. 13.
    Takahashi M, Ritz J, Cooper GM. Activation of a novel human transforming gene, ret, by DNA rearrangement. Cell. 1985;42:581–8.PubMedGoogle Scholar
  14. 14.
    Eng C. RET proto-oncogene in the development of human cancer. J Clin Oncol. 1999;17:380–93.PubMedGoogle Scholar
  15. 15.
    Hubner RA, Houlston RS. Molecular advances in medullary thyroid cancer diagnostics. Clin Chim Acta. 2006;370:2–8.PubMedGoogle Scholar
  16. 16.
    Eng C, Mulligan LM, Smith DP, et al. Low frequency of germline mutations in the RET proto-oncogene in patients with apparently sporadic medullary thyroid carcinoma. Clin Endocrinol. 1995;43:123–7.Google Scholar
  17. 17.
    Elisei R, Cosci B, Romei C, et al. Prognostic significance of somatic RET oncogene mutations in sporadic medullary thyroid cancer: a 10-year follow-up study. J Clin Endocrinol Metab. 2007;93:682–7.PubMedGoogle Scholar
  18. 18.
    Marsh DJ, Learoyd DL, Andrew SD, et al. Somatic mutations in the RET protooncogene in sporadic medullary thyroid carcinoma. Clin Endocrinol. 1996;44:249–57.Google Scholar
  19. 19.
    Brandi ML, Gagel RF, Angeli A, et al. Guidelines for diagnosis and therapy of MEN type 1 and type 2. J Clin Endocrinol Metab. 2001;86:5658–71.PubMedGoogle Scholar
  20. 20.
    Kouvaraki MA, Shapiro SE, Perrier ND, et al. RET proto-oncogene: a review and update of genotype-phenotype correlations in hereditary medullary thyroid cancer and associated endocrine tumors. Thyroid. 2005;15:531–44.PubMedGoogle Scholar
  21. 21.
    Gagel RF, Levy ML, Donovan DT, et al. Multiple endocrine neoplasia type 2a associated with cutaneous lichen amyloidosis. Ann Intern Med. 1989;111:802–6.PubMedGoogle Scholar
  22. 22.
    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;1:603–7.PubMedGoogle Scholar
  23. 23.
    Farndon JR, Leight GS, Dilley WG, et al. Familial medullary thyroid carcinoma without associated endocrinopathies: a distinct clinical entity. Br J Surg. 1986;73:278–81.PubMedGoogle Scholar
  24. 24.
    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;276:1575–9.PubMedGoogle Scholar
  25. 25.
    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;92:4725–9.PubMedGoogle Scholar
  26. 26.
    Carlson KM, Bracamontes J, Jackson CE, et al. Parent-of-origin effects in multiple endocrine neoplasia type 2B. Am J Hum Genet. 1994;55:1076–82.PubMedCentralPubMedGoogle Scholar
  27. 27.
    Force ATAGT, Kloos RT, Eng C, Evans DB, et al. Medullary thyroid cancer: management guidelines of the American Thyroid Association. Thyroid. 2009;19:565–612.Google Scholar
  28. 28.
    Rosenthal M, Diekema D. Pediatric ethics guidelines for hereditary medullary thyroid cancer. Int J Pediatr Endocrinol. 2011;2011:847603.PubMedCentralPubMedGoogle Scholar
  29. 29.
    Quayle FJ, Moley JF. Medullary thyroid carcinoma: management of lymph node metastases. Curr Treat Options Oncol. 2005;6:347–54.PubMedGoogle Scholar
  30. 30.
    Pacini F, Fontanelli M, Fugazzola L, et al. Routine measurement of serum calcitonin in nodular thyroid diseases allows the preoperative diagnosis of unsuspected sporadic medullary thyroid carcinoma. J Clin Endocrinol Metab. 1994;78:826–9.PubMedGoogle Scholar
  31. 31.
    Elisei R. Impact of routine measurement of serum calcitonin on the diagnosis and outcome of medullary thyroid cancer: experience in 10,864 patients with nodular thyroid disorders. J Clin Endocrinol Metab. 2004;89:163–8.PubMedGoogle Scholar
  32. 32.
    Gibelin H, Essique D, Jones C, et al. Increased calcitonin level in thyroid nodules without medullary carcinoma. Br J Surg. 2005;92:574–8.PubMedGoogle Scholar
  33. 33.
    Costante G, Meringolo D, Durante C, et al. Predictive value of serum calcitonin levels for preoperative diagnosis of medullary thyroid carcinoma in a cohort of 5817 consecutive patients with thyroid nodules. J Clin Endocrinol Metab. 2006;92:450–5.PubMedGoogle Scholar
  34. 34.
    Daniels GH. Screening for medullary thyroid carcinoma with serum calcitonin measurements in patients with thyroid nodules in the United States and Canada. Thyroid. 2011;21:1199–207.PubMedGoogle Scholar
  35. 35.
    Colombo C, Verga U, Mian C, et al. Comparison of calcium and pentagastrin tests for the diagnosis and follow-up of medullary thyroid cancer. J Clin Endocrinol Metab. 2012;97:905–13.PubMedGoogle Scholar
  36. 36.
    Borget I, De Pouvourville G, Schlumberger M. Calcitonin determination in patients with nodular thyroid disease. J Clin Endocrinol Metab. 2006;92:425–7.Google Scholar
  37. 37.
    Cheung K, Roman SA, Wang TS, et al. Calcitonin measurement in the evaluation of thyroid nodules in the United States: a cost-effectiveness and decision analysis. J Clin Endocrinol Metab. 2008;93:2173–80.PubMedGoogle Scholar
  38. 38.
    Gharib H, Papini E, Paschke R, et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: executive summary of recommendations. Endocr Pract. 2010;16:468–75.PubMedGoogle Scholar
  39. 39.
    Guerrero MA, Lindsay S, Suh I, et al. Medullary thyroid cancer: it is a pain in the neck? J Cancer. 2011;2:200–5.PubMedCentralPubMedGoogle Scholar
  40. 40.
    Boi F, Maurelli I, Pinna G, et al. Calcitonin measurement in wash-out fluid from fine needle aspiration of neck masses in patients with primary and metastatic medullary thyroid carcinoma. J Clin Endocrinol Metab. 2007;92:2115–8.PubMedGoogle Scholar
  41. 41.
    Cohen R, Campos JM, Salaun C, et al. Preoperative calcitonin levels are predictive of tumor size and postoperative calcitonin normalization in medullary thyroid carcinoma. Groupe d’Etudes des Tumeurs a Calcitonine (GETC). J Clin Endocrinol Metab. 2000;85:919–22.PubMedGoogle Scholar
  42. 42.
    Machens A. Prospects of remission in medullary thyroid carcinoma according to basal calcitonin level. J Clin Endocrinol Metab. 2005;90:2029–34.PubMedGoogle Scholar
  43. 43.
    Machens A, Ukkat J, Hauptmann S, et al. Abnormal carcinoembryonic antigen levels and medullary thyroid cancer progression: a multivariate analysis. Arch Surg. 2007;142:289–93.PubMedGoogle Scholar
  44. 44.
    Blind E, Schmidt-Gayk H, Sinn HP, et al. Chromogranin A as tumor marker in medullary thyroid carcinoma. Thyroid. 1992;2:5–10.PubMedGoogle Scholar
  45. 45.
    Romei C, Cosci B, Renzini G, et al. RET genetic screening of sporadic medullary thyroid cancer (MTC) allows the preclinical diagnosis of unsuspected gene carriers and the identification of a relevant percentage of hidden familial MTC (FMTC). Clin Endocrinol. 2011;74:241–7.Google Scholar
  46. 46.
    Bugalho MJ, Domingues R, Santos JR, et al. Mutation analysis of the RET protooncogene and early thyroidectomy: results of a Portuguese cancer centre. Surgery. 2007;141:90–5.PubMedGoogle Scholar
  47. 47.
    Moley JF, DeBenedetti MK. Patterns of nodal metastases in palpable medullary thyroid carcinoma: recommendations for extent of node dissection. Ann Surg. 1999;229:880–7.PubMedCentralPubMedGoogle Scholar
  48. 48.
    American Thyroid Association Surgery Working Group, American Association of Endocrine Surgeons, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society, Carty SE, Cooper DS, et al. Consensus statement on the terminology and classification of central neck dissection for thyroid cancer. Thyroid. 2009;19:1153–8.Google Scholar
  49. 49.
    de Groot JWB, Links TP, Sluiter WJ, et al. Locoregional control in patients with palpable medullary thyroid cancer: results of standardized compartment-oriented surgery. Head Neck. 2007;29:857–63.PubMedGoogle Scholar
  50. 50.
    Scollo C. Rationale for central and bilateral lymph node dissection in sporadic and hereditary medullary thyroid cancer. J Clin Endocrinol Metab. 2003;88:2070–5.PubMedGoogle Scholar
  51. 51.
    Machens A, Hauptmann S, Dralle H. Increased risk of lymph node metastasis in multifocal hereditary and sporadic medullary thyroid cancer. World J Surg. 2007;31:1960–5.PubMedGoogle Scholar
  52. 52.
    Kazaure HS, Roman SA, Sosa JA. Medullary thyroid microcarcinoma. Cancer. 2011;118:620–7.PubMedGoogle Scholar
  53. 53.
    Machens A, Hauptmann S, Dralle H. Prediction of lateral lymph node metastases in medullary thyroid cancer. Br J Surg. 2008;95:586–91.PubMedGoogle Scholar
  54. 54.
    Kebebew E, Ituarte PH, Siperstein AE, et al. Medullary thyroid carcinoma: clinical characteristics, treatment, prognostic factors, and a comparison of staging systems. Cancer. 2000;88:1139–48.PubMedGoogle Scholar
  55. 55.
    Dralle H, Damm I, Scheumann GF, et al. Frequency and significance of cervicomediastinal lymph node metastases in medullary thyroid carcinoma: results of a compartment-oriented microdissection method. Henry Ford Hosp Med J. 1992;40:264–7.PubMedGoogle Scholar
  56. 56.
    Machens A, Holzhausen H-J, Dralle H. Contralateral cervical and mediastinal lymph node metastasis in medullary thyroid cancer: systemic disease? Surgery. 2006;139:28–32.PubMedGoogle Scholar
  57. 57.
    Tung WS, Vesely TM, Moley JF. Laparoscopic detection of hepatic metastases in patients with residual or recurrent medullary thyroid cancer. Surgery. 1995;118:1024–9; discussion 1029–30.PubMedGoogle Scholar
  58. 58.
    Edge SB, Byrd DR, Compton CC, editors. AJCC cancer staging manual. 7th ed. New York: Springer; 2010.Google Scholar
  59. 59.
    Modigliani E, Cohen R, Campos JM, et al. Prognostic factors for survival and for biochemical cure in medullary thyroid carcinoma: results in 899 patients. The GETC Study Group. Groupe d’etude des tumeurs a calcitonine. Clin Endocrinol (Oxf). 1998;48:265–73.Google Scholar
  60. 60.
    Pelizzo MR, Boschin IM, Bernante P, et al. Natural history, diagnosis, treatment and outcome of medullary thyroid cancer: 37 years experience on 157 patients. Eur J Surg Oncol. 2007;33:493–7.PubMedGoogle Scholar
  61. 61.
    Bhattacharyya N. A population-based analysis of survival factors in differentiated and medullary thyroid carcinoma. Otolaryngol Head Neck Surg. 2003;128:115–23.PubMedGoogle Scholar
  62. 62.
    Roman S, Lin R, Sosa JA. Prognosis of medullary thyroid carcinoma. Cancer. 2006;107:2134–42.PubMedGoogle Scholar
  63. 63.
    Ahmed SR, Ball DW. Incidentally discovered medullary thyroid cancer: diagnostic strategies and treatment. J Clin Endocrinol Metab. 2011;96:1237–45.PubMedCentralPubMedGoogle Scholar
  64. 64.
    Valle LA, Kloos RT. The prevalence of occult medullary thyroid carcinoma at autopsy. J Clin Endocrinol Metab. 2011;96:E109–13.PubMedGoogle Scholar
  65. 65.
    Davidson BJ, Burman KD. Cancer of the thyroid and parathyroid. In: Harrison LB, Sessions RB, Hong WK, editors. Head and neck cancer: a multidisciplinary approach. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2008. p. 992.Google Scholar
  66. 66.
    Yip DT, Hassan M, Pazaitou-Panayiotou K, et al. Preoperative basal calcitonin and tumor stage correlate with postoperative calcitonin normalization in patients undergoing initial surgical management of medullary thyroid carcinoma. Surgery. 2011;150:1168–77.PubMedGoogle Scholar
  67. 67.
    Machens A, Gimm O, Ukkat J, et al. Improved prediction of calcitonin normalization in medullary thyroid carcinoma patients by quantitative lymph node analysis. Cancer. 2000;88:1909–15.PubMedGoogle Scholar
  68. 68.
    Pellegriti G, Leboulleux S, Baudin E, et al. Long-term outcome of medullary thyroid carcinoma in patients with normal postoperative medical imaging. Br J Cancer. 2003;88:1537–42.PubMedCentralPubMedGoogle Scholar
  69. 69.
    Franc S, Niccoli-Sire P, Cohen R, et al. Complete surgical lymph node resection does not prevent authentic recurrences of medullary thyroid carcinoma. Clin Endocrinol. 2001;55:403–9.Google Scholar
  70. 70.
    Miyauchi A, Onishi T, Morimoto S, et al. Relation of doubling time of plasma calcitonin levels to prognosis and recurrence of medullary thyroid carcinoma. Ann Surg. 1984;199:461–6.PubMedCentralPubMedGoogle Scholar
  71. 71.
    Gawlik T, d’Amico A, Szpak-Ulczok S, et al. The prognostic value of tumor markers doubling times in medullary thyroid carcinoma-preliminary report. Thyroid Res. 2010;3:10.PubMedCentralPubMedGoogle Scholar
  72. 72.
    Barbet J. Prognostic impact of serum calcitonin and carcinoembryonic antigen doubling times in patients with medullary thyroid carcinoma. J Clin Endocrinol Metab. 2005;90:6077–84.PubMedGoogle Scholar
  73. 73.
    Meijer JAA, le Cessie S, van den Hout WB, et al. Calcitonin and carcinoembryonic antigen doubling times as prognostic factors in medullary thyroid carcinoma: a structured meta-analysis. Clin Endocrinol. 2010;72:534–42.Google Scholar
  74. 74.
    Busnardo B, Girelli ME, Simioni N, et al. Nonparallel patterns of calcitonin and carcinoembryonic antigen levels in the follow-up of medullary thyroid carcinoma. Cancer. 1984;53:278–85.PubMedGoogle Scholar
  75. 75.
    Fialkowski E, DeBenedetti M, Moley J. Long-term outcome of reoperations for medullary thyroid carcinoma. World J Surg. 2008;32:754–65.PubMedGoogle Scholar
  76. 76.
    Giraudet AL, Vanel D, Leboulleux S, et al. Imaging medullary thyroid carcinoma with persistent elevated calcitonin levels. J Clin Endocrinol Metab. 2007;92:4185–90.Google Scholar
  77. 77.
    Ong SC, Schoder H, Patel SG, et al. Diagnostic accuracy of 18F-FDG PET in restaging patients with medullary thyroid carcinoma and elevated calcitonin levels. J Nucl Med. 2007;48:501–7.PubMedGoogle Scholar
  78. 78.
    Treglia G, Castaldi P, Villani MF, et al. Comparison of 18F-DOPA, 18F-FDG and 68Ga-somatostatin analogue PET/CT in patients with recurrent medullary thyroid carcinoma. Eur J Nucl Med Mol Imaging. 2012;39:569–80.PubMedGoogle Scholar
  79. 79.
    Beheshti M, Pocher S, Vali R, et al. The value of 18F-DOPA PET-CT in patients with medullary thyroid carcinoma: Comparison with 18F-FDG PET-CT. Eur Radiol. 2009;19:1425–34.PubMedGoogle Scholar
  80. 80.
    Kauhanen S, Schalin-Jantti C, Seppanen M, et al. Complementary roles of 18F-DOPA PET/CT and 18F-FDG PET/CT in medullary thyroid cancer. J Nucl Med. 2011;52:1855–63.PubMedGoogle Scholar
  81. 81.
    Naswa N, Sharma P, Suman Kc S, et al. Prospective evaluation of 68Ga-DOTANOC PET-CT in patients with recurrent medullary thyroid carcinoma. Nucl Med Commun. 2012;33:766–74.PubMedGoogle Scholar
  82. 82.
    Conry BG, Papathanasiou ND, Prakash V, et al. Comparison of (68)Ga-DOTATATE and (18)F-fluorodeoxyglucose PET/CT in the detection of recurrent medullary thyroid carcinoma. Eur J Nucl Med Mol Imaging. 2010;37:49–57.PubMedGoogle Scholar
  83. 83.
    Lodish M, Dagalakis U, Chen CC, et al. 111In-Octreotide scintigraphy for identification of metastatic medullary thyroid carcinoma in children and adolescents. J Clin Endocrinol Metab. 2012;97:E207–12.PubMedCentralPubMedGoogle Scholar
  84. 84.
    Tisell LE, Hansson G, Jansson S, et al. Reoperation in the treatment of asymptomatic metastasizing medullary thyroid carcinoma. Surgery. 1986;99:60–6.PubMedGoogle Scholar
  85. 85.
    Moley JF, Dilley WG, DeBenedetti MK. Improved results of cervical reoperation for medullary thyroid carcinoma. Ann Surg. 1997;225:734–40.PubMedCentralPubMedGoogle Scholar
  86. 86.
    van Heerden JA, Grant CS, Gharib H, et al. Long-term course of patients with persistent hypercalcitoninemia after apparent curative primary surgery for medullary thyroid carcinoma. Ann Surg. 1990;212:395–400.PubMedCentralPubMedGoogle Scholar
  87. 87.
    Moley JF, DeBenedetti MK, Dilley WG, et al. Surgical management of patients with persistent or recurrent medullary thyroid cancer. J Intern Med. 1998;243:521–6.PubMedGoogle Scholar
  88. 88.
    Schwartz DL, Rana V, Shaw S, et al. Postoperative radiotherapy for advanced medullary thyroid cancer—local disease control in the modern era. Head Neck. 2008;30:883–8.Google Scholar
  89. 89.
    Terezakis SA, Lee KS, Ghossein RA, et al. Role of external beam radiotherapy in patients with advanced or recurrent nonanaplastic thyroid cancer: Memorial Sloan-Kettering Cancer Center experience. Int J Radiat Oncol Biol Phys. 2009;73:795–801.PubMedGoogle Scholar
  90. 90.
    Fife KM, Bower M, Harmer CL. Medullary thyroid cancer: the role of radiotherapy in local control. Eur J Surg Oncol. 1996;22:588–91.PubMedGoogle Scholar
  91. 91.
    Brierley J, Tsang R, Simpson WJ, et al. Medullary thyroid cancer: analyses of survival and prognostic factors and the role of radiation therapy in local control. Thyroid. 1996;6:305–10.PubMedGoogle Scholar
  92. 92.
    Martinez SR, Beal SH, Chen A, et al. Adjuvant external beam radiation for medullary thyroid carcinoma. J Surg Oncol. 2010;102:175–8.PubMedCentralPubMedGoogle Scholar
  93. 93.
    Wells SA, Robinson BG, Gagel RF, et al. Vandetanib in patients with locally advanced or metastatic medullary thyroid cancer: a randomized, double-blind phase III trial. J Clin Oncol. 2012;30:134–41.PubMedCentralPubMedGoogle Scholar
  94. 94.
    Chatal JF. Survival improvement in patients with medullary thyroid carcinoma who undergo pretargeted anti-carcinoembryonic-antigen radioimmunotherapy: a collaborative study with the French Endocrine Tumor Group. J Clin Oncol. 2006;24:1705–11.PubMedGoogle Scholar
  95. 95.
    Salaun P-Y, Campion L, Bournaud C, et al. Phase II trial of anticarcinoembryonic antigen pretargeted radioimmunotherapy in progressive metastatic medullary thyroid carcinoma: biomarker response and survival improvement. J Nucl Med. 2012;53:1185–92.PubMedGoogle Scholar
  96. 96.
    Iten F, Muller B, Schindler C, et al. Response to [90Yttrium-DOTA]-TOC treatment is associated with long-term survival benefit in metastasized medullary thyroid cancer: a phase II clinical trial. Clin Cancer Res. 2007;13:6696–702.PubMedGoogle Scholar
  97. 97.
    Castellani MR, Seregni E, Maccauro M, et al. MIBG for diagnosis and therapy of medullary thyroid carcinoma: is there still a role? Q J Nucl Med Mol Imaging. 2008;52:430–40.PubMedGoogle Scholar
  98. 98.
    Pasieka JL, McEwan AJB, Rorstad O. The palliative role of 131I-MIBG and 111In-octreotide therapy in patients with metastatic progressive neuroendocrine neoplasms. Surgery. 2004;136:1218–26.PubMedGoogle Scholar
  99. 99.
    Mahler C, Verhelst J, de Longueville M, et al. Long-term treatment of metastatic medullary thyroid carcinoma with the somatostatin analogue octreotide. Clin Endocrinol. 1990;33:261–9.Google Scholar
  100. 100.
    Chen H, Roberts JR, Ball DW, et al. Effective long-term palliation of symptomatic, incurable metastatic medullary thyroid cancer by operative resection. Ann Surg. 1998;227:887–95.PubMedCentralPubMedGoogle Scholar
  101. 101.
    Akyildiz HY, Mitchell J, Milas M, et al. Laparoscopic radiofrequency thermal ablation of neuroendocrine hepatic metastases: long-term follow-up. Surgery. 2010;148:1288–93.PubMedGoogle Scholar
  102. 102.
    Lorenz K, Brauckhoff M, Behrmann C, et al. Selective arterial chemoembolization for hepatic metastases from medullary thyroid carcinoma. Surgery. 2005;138:986–93.PubMedGoogle Scholar
  103. 103.
    Fromigue J. Chemoembolization for liver metastases from medullary thyroid carcinoma. J Clin Endocrinol Metab. 2006;91:2496–9.PubMedGoogle Scholar

Copyright information

© K. Alok Pathak, Richard W. Nason, Janice L. Pasieka, Rehan Kazi, Raghav C. Dwivedi 2015

Authors and Affiliations

  1. 1.Section of General Surgery and Surgical OncologyUniversity of CalgaryCalgaryCanada

Personalised recommendations