Most malignant thyroid cancers are papillary, followed by follicular, medullary, and thyroid lymphoma. The subcapsular sinus drains into trabecular sinuses and finally into medullary sinuses. Thyroglobulin is not produced by medullary or anaplastic thyroid carcinoma. In 1961 Sipple described a combination of a pheochromocytoma, medullary thyroid carcinoma and parathyroid adenoma. Both syndromes are characterized by pheochromocytoma as well as thyroid cancer (thyroid medullary carcinoma). The outer segment of the medullary collecting duct follows the cortical collecting duct. Calcitonin levels remain a valuable marker to detect recurrence of medullary thyroid carcinoma after thyroidectomy. Sympathetic nerve fiber impulses stimulate the release of adrenal medullary hormones. Autonomic Inspiration is controlled by the pontine respiratory center and both medullary respiratory centers. This causes a syndrome called medial medullary syndrome. The pons first evolved as an offshoot of the medullary reticular formation. Surgery and radiation therapy have been the major treatments for medullary thyroid carcinoma. It is helpful in making an early diagnosis of medullary carcinoma of thyroid. In the medullary collecting duct specifically, vasopressin upregulates urea transporter A1. Patients with medullary, anaplastic, and most Hurthle-cell cancers do not benefit from this therapy.