Pediatric Medullary Thyroid Cancer

Pediatric Medullary Thyroid Cancer

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Summary

Medullary thyroid cancer (MTC) is a type of thyroid cancer that originates in the parafollicular cells, which are known as “C” cells because they secrete the hormone calcitonin.

Types

There are two types of MTC:

  • Inherited MTC runs in families.
  • Sporadic MTC does not run in families.

Causes

The exact cause of MTC is unknown. As with all types of cancers, it is caused by the growth of abnormal cells that multiply rapidly, forming what is known as a tumor.

Risk Factors

Risk factors for MTC may include:

  • A family history of MTC
  • A family history of multiple endocrine neoplasia (MEN)
  • A prior history of pheochromocytoma, mucosal neuromas or hyperparathyroidism

Symptoms

Symptoms of MTC may include:

  • A lump on the thyroid gland
  • Difficulty breathing
  • Cough (sometimes with blood)
  • Diarrhea
  • Goiter (enlarged thyroid)

Diagnosis

There are several methods that are used for diagnosing MTC. Your child’s doctor may use a combination of these methods:

  • History and physical exam
  • Blood tests
  • Ultrasound (a noninvasive test that uses sound waves to take pictures of the thyroid)
  • Fine needle biopsy (removal of a small amount of thyroid tissue using a thin needle; the tissue is later examined under a microscope)

Treatment

The extent of surgical and medical treatment will depend on the extent of your child’s disease. Initial treatment consists of surgical excision of the thyroid gland. Medullary thyroid carcinoma can spread through the body’s lymphatic system to lymph nodes in the neck adjacent to the thyroid gland and beyond, and surgical removal of these lymph nodes may also be required. In more advanced cases it may spread to the lungs.

Medullary thyroid cancer is not particularly sensitive to radioactive iodine ablation or chemotherapy, so surgical resection is the mainstay of treatment. Once surgical treatment is complete, in some cases radiation or other interventions may be required to treat extensive or residual disease.

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