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Medullary thyroid carcinoma

Management of medullary thyroid carcinoma (MTC) remains controversial despite many advances over the past five decades. The discovery of the genetic basis of hereditary forms of MTC and their associated syndromes, the identification of prognostic factors and long-term follow-up studies have greatly added to our knowledge of the biology of the disease and have demonstrated the benefit of early detection in genetically susceptible individuals. However, some of the basic controversies regarding the management of patients with MTC remain unresolved. The extent of primary surgical management, including both the optimal extent of cervical lymph node dissection and the ideal extent of surgical excision of the primary tumor, remains controversial. Similarly, the management of patients with persistent hypercalcitoninemia after primary surgery remains a contentious issue.