Μυελοειδές καρκίνωμα θυρεοειδούς σαν τυχαίο εύρημα μετά από λοβεκτομή

IS PROPHYLACTIC CENTRAL LYMPH NODE DISSECTION ALWAYS INDICATED IN THE MANAGEMENT OF MEDULLARY THYROID CANCER?

Medullary thyroid cancer (MTC) is a more aggressive thyroid malignancy compared to differentiated thyroid cancer and it is associated with a high incidence of metastases to cervical lymph nodes. Moreover, adjuvant radioiodine ablation therapy is not effective in the management of MTC. Prophylactic bilateral central lymph node dissection (CLND) is recommended for patients with MTC(*). Despite some controversy, however, prophylactic CLND could be avoided in patients with small intrathyroidal MTC, with low (< 20 pg/ml) preoperative serum calcitonin levels, because lymphatic spread is very rare in this case (**).

(*) Wells SA et al. Thyroid 2015; 25: 567
(**) Machens A, et al. J Clin Endocrinol Metab 2010; 95: 2655