Incidentally discovered thyroid
C-cell hyperplasia;
practical significance in clinical practice
C-cell
hyperplasia (CCH) is characterized by the increased number of C
(parafollicular) cells within the thyroid parenchyma.
CCH can be classified as
physiologic (reactive) or neoplastic.
---REACTIVE CCH has no malignant potential
and can be observed in association with many other thyroid diseases (including
differentiated thyroid cancer)
---NEOPLASTIC CCH should be
considered as a preneoplastic stage in the spectrum of C-cell disease,
ultimately leading to the development of medullary thyroid cancer (MTC).
Neoplastic CCH is commonly observed in patients with germ-line mutations in the
RET oncogene (commonly in families with a history of hereditary MTC
[familial MTC or MEN2]).
CCH should be considered in patients with
hypercalcitoninemia without nodular thyroidopathy.
Total thyroidectomy (which
is commonly performed for the majority of thyroid diseases) is adequate
treatment and achieves cure, even in patients with neoplastic CCH.
There is no
role for cervical lymph node dissection in patients with pure CCH.
Σχόλια
Δημοσίευση σχολίου