Presentation
Until today, 20/50 M918V carriers underwent thyroidectomy and all presented MTC/C-cell hyperplasia; the remainder carriers are on clinical follow-up. None of the M918V carriers presented clinical features of MEN 2B. [ncbi.nlm.nih.gov]
Entire Body System
- Asymptomatic
In addition, the genetic study allows the identification of asymptomatic carriers of hereditary forms of MTC. [ncbi.nlm.nih.gov]
She was asymptomatic except for slight interscapular pruritus of several years duration. Physical examination revealed a right thyroid nodule, 0.8 cm in diameter, and a 2-by-3-cm papular and pigmented FULL TEXT [annals.org]
- Pain
Neck pain. Pain in the front of the neck may be related to the growth of a thyroid tumor. This pain can also extend to the ears. Hoarseness. The nerve that controls your vocal cords runs alongside the trachea near the thyroid. [healthline.com]
As a thoracic aortic aneurysm grows, some people may notice: Tenderness or pain in the chest Back pain Hoarseness Cough Shortness of breath Aortic aneurysms can develop anywhere along the aorta, which runs from your heart through your chest and abdomen [mayoclinic.org]
These may include: a large mass in the neck pain in the neck, jaw, or ear choking sensations People with cancer that has spread to the nerves that control the vocal cords may also experience hoarseness or changes in their voice. [medicalnewstoday.com]
Depending on the size, location and progression rate of dilatation/dissection, patients may be asymptomatic or may present dyspnea, cough, jaw, neck, chest or back pain, head, neck or upper limb edema, difficulty swallowing, voice hoarseness, pale skin [orpha.net]
Diarrhea, flushes, and bone pain are also problems. Levothyroxine can cause sweating, anxiety, nausea, and other problems. [myresults.org]
- Goiter
Of the index cases with noncysteine mutations, 43.4% presented with a multinodular goiter and high basal calcitonin; they were older at diagnosis than those with mutation in exon 10 and had more multifocal medullary thyroid carcinoma, but no difference [ncbi.nlm.nih.gov]
Biological characteristics of rat medullary thyroid carcinoma cell line CA-77 in different culture conditions; 大鼠甲状腺髓样癌细胞系CA-77在不同培养条件下的生物学特性 4) Sporadic medullary thyroid carcinoma 散发型甲状腺髓样癌 5) Familial goiter 家族性甲状腺肿 6) familial parathyroid hyperplasia [dictall.com]
The second group includes familial syndromes characterized by a predominance of FNMTC, such as pure familial PTC, familial PTC with papillary renal cell carcinoma, and familial PTC with multinodular goiter. [shifrinmd.com]
This second group also includes familial syndromes characterized by a predominance of NMTC, such as pure familial (f) PTC with or without oxyphilia, fPTC with papillary renal cell carcinoma, and fPTC with multinodular goiter. [nature.com]
- Weakness
Those with Marfan syndrome may have a weakness in the aortic wall that makes them more susceptible to aneurysm. [mayoclinic.org]
The C-cells make a hormone called calcitonin which has a weak effect on bone growth and blood calcium levels. Since calcitonin's effect is so weak, it does not need to be replaced after removal of the thyroid like thyroid hormone. [columbiasurgery.org]
To develop an aneurysm in the aorta there has to be some weakness of the wall going on that can predispose an aneurysm to rupture as well. [khanacademy.org]
In contrast, score 2 indicates a weak recommendation or a suggestion that may not be appropriate for every patient, depending on the context, patient values, and preferences. [karger.com]
Only weak (level C) evidence suggests the use of magnetic resonance imaging for these patients instead of computed tomographic imaging in an effort to reduce such harmful exposure [3]. [cardiothoracicsurgery.biomedcentral.com]
- Pathologist
The pathologist has a critical function in the identification of these syndromes by recognizing characteristic patterns of thyroid morphologic findings, and often involves interaction between pathologists and surgeons, which may lead to further molecular [nature.com]
Histologically MTC is characterized by a solid mass of cells with uniform polygonal shapes and finely granular eosinophilic cytoplasm.(2) Pathologists have described the presence of amyloid deposition as being pathognomonic for MTC and are found in one [ncbi.nlm.nih.gov]
Respiratoric
- Aspiration
Abstract Serum calcitonin screening has recently been found to be a useful supplement to fine-needle aspiration biopsy, ultrasound and radionuclide imaging in the evaluation of thyroid nodules. [ncbi.nlm.nih.gov]
Here we present a 26 year-old patient with bilateral neck swelling, where fine needle aspiration (FNA) cytology of the nodule showed medullary thyroid carcinoma. Hence the siblings were investigated for familial MTC. [ukm.pure.elsevier.com]
Fine needle aspiration (FNA) — FNA biopsy is the most accurate test for evaluating thyroid nodules. The biopsy may be performed under ultrasound guidance. [endocrinediseases.org]
Needle aspiration suggested papillary carcinoma in 6/7, who were all treated by total thyroidectomy. Four patients with enlarged nodes also had bilateral neck disection. [onlinelibrary.wiley.com]
- Cough
Coughing. Thyroid cancer can sometimes cause a persistent cough. You should see your doctor if you have a cough that’s unrelated to a cold or one that doesn’t go away. Trouble swallowing (dysphagia). [healthline.com]
Depending on the size, location and progression rate of dilatation/dissection, patients may be asymptomatic or may present dyspnea, cough, jaw, neck, chest or back pain, head, neck or upper limb edema, difficulty swallowing, voice hoarseness, pale skin [orpha.net]
Common symptoms of MTC can include: swelling in the neck near the thyroid gland, which corresponds to enlarged lymph nodes cough, sometimes producing blood difficulty swallowing, sometimes causing pain shortness of breath difficulty breathing, because [medicalnewstoday.com]
But as it grows, you could notice any of the following problems: Neck, throat pain Lump in your neck Difficulty swallowing Vocal changes, hoarseness Cough What Causes It? There is no clear reason why most people get thyroid cancer. [webmd.com]
As a thoracic aortic aneurysm grows, some people may notice: Tenderness or pain in the chest Back pain Hoarseness Cough Shortness of breath Aortic aneurysms can develop anywhere along the aorta, which runs from your heart through your chest and abdomen [mayoclinic.org]
- Dyspnea
Depending on the size, location and progression rate of dilatation/dissection, patients may be asymptomatic or may present dyspnea, cough, jaw, neck, chest or back pain, head, neck or upper limb edema, difficulty swallowing, voice hoarseness, pale skin [orpha.net]
Shortness of breath (dyspnea). Similar to trouble swallowing, if a thyroid tumor is large enough, it can push against the windpipe and interfere with breathing. [healthline.com]
Symptoms of extensive local disease include dysphagia, hoarseness, dyspnea, stridor and coughing. [ncbi.nlm.nih.gov]
- Sore Throat
throat that does not get better pain in the neck However, not all neck lumps are cancer. [medicalnewstoday.com]
Gastrointestinal
- Diarrhea
The tumor produces high levels of calcitonin, a hormone that may cause severe diarrhea. Cushing syndrome. [healthline.com]
In MTC, the flushing, diarrhea, and itching (pruritus) are all caused by elevated levels of calcitonin gene products (calcitonin or calcitonin gene-related peptide).[4] Alternatively, the flushing and diarrhea observed in carcinoid syndrome is caused [en.wikipedia.org]
One third will present with intractable diarrhea. Diarrhea is caused by increased gastrointestinal secretion and hypermotility due to the hormones secreted by the tumor (calcitonin, prostaglandins, serotonin, or VIP). [endocrineweb.com]
- Dysphagia
Trouble swallowing (dysphagia). If a thyroid tumor becomes large enough, it can press on the esophagus and make swallowing difficult. Shortness of breath (dyspnea). [healthline.com]
Other features seen less commonly were neck pain, dysphagia, hoarseness of voice, diarrhea, loss of appetite and weight, hypertension, palpitation, and abdominal pain. [ijpmonline.org]
These tumors tend to be located in the posterior thyroid, and therefore can compress or invade local structures causing hoarseness, dysphagia, or respiratory difficulty. [theoncologist.onlinelibrary.wiley.com]
Symptoms of extensive local disease include dysphagia, hoarseness, dyspnea, stridor and coughing. [ncbi.nlm.nih.gov]
Psychiatrical
- Suggestibility
We suggest that parental imprinting may play a role in the ethiology of HSCR caused by mutations in the RET protooncogene. [ncbi.nlm.nih.gov]
- Aggressive Behavior
Thus, the presence of this mutation in some sporadic tumors could be one possible explanation for a more aggressive behavior than fMTC tumors, which harbor different RET mutations associated with less aggressive disease. [onlinelibrary.wiley.com]
behavior of M918V MTC. [erc.bioscientifica.com]
In general, the tumors in FNMTC are associated with early age of onset, usually associated with benign thyroid conditions, increased incidence of multifocality, bilateral tumors, nodal involvement, and recurrence, with some having a more aggressive behavior [nature.com]
Neurologic
- Lethargy
Lethargy. Many people with advanced cancer may feel physically, emotionally, or mentally tired. The causes of fatigue during cancer are complex and not well understood. Weight loss. [healthline.com]
Disseminated disease may cause symptoms of weight loss, lethargy, and bone pain. MTC patients often present with diarrhea due to an increased secretion of an intestinal electrolyte which occurs secondary to high plasma calcitonin levels. [atlasgeneticsoncology.org]
Workup
Placement of the autograft in the forearm facilitates the workup and management of any hyperparathyroidism that may develop. [theoncologist.onlinelibrary.wiley.com]
New calcitonin elevation, rapid calcitonin doubling time, or onset of palpable disease should prompt a metastatic workup. Workup for detection of local disease should start with a neck ultrasound. [ncbi.nlm.nih.gov]
Treatment
Two underwent non-normative thyroidectomy either two or four times without physician awareness or diagnosis of this disease at initial treatment, but with elevated Ct. [ncbi.nlm.nih.gov]
Prognosis
Several disease-causing mutations of this gene have been identified and their clinical prognosis described. The penetrance of these mutations is high; as such, carriers progress to develop medullary thyroid carcinoma at a young age. [ncbi.nlm.nih.gov]
Here are the latest prognosis statistics related to stage: Stage 1: Prognosis is extremely good at this stage when the tumor is less than 2 centimeters across, and hasn’t grown beyond the thyroid. [healthline.com]
As with any malignancy, staging of disease is an important part of management to inform treatment planning and prognosis. [radiopaedia.org]
In the Italian family the mean age at diagnosis is 25.8 years (S.D. 7.8) and interestingly none of the patients have distant metastasis, suggesting a possibly better prognosis compared to RET-related fMTC. [endocrine-abstracts.org]
Etiology
The femoropopliteal aneurysm can be accompanied by an AAA in up to 70% of the cases.13,14 Etiology The etiology and pathogenesis of acquired aneurysmal disease are complex and have yet to be fully elucidated. [revespcardiol.org]
Furthermore, the 10‐year probability of lack of progression of disease, which was decreased in fMTCs compared to spMTCs, confirms our findings, similar to previous reports.9, 22, 24, 26, 28 The etiology of such differences in the clinical outcome between [onlinelibrary.wiley.com]
Etiology Medullary thyroid cancer can be classified into 4 types: 1) Sporadic 2) Hereditary MEN2A 3) Hereditary MEN2B 4) Hereditary familial medullary thyroid cancer (FMTC) Epidemiology In the United States, thyroid cancer comprises 3% of new malignancies [atlasgeneticsoncology.org]
Epidemiology
epidemiology, and end results database analysis Chunping Liu 1,*, Qiuyang Zhao 1,*, Zhi Li 1, Shuntao Wang 1, Yiquan More information mr.sc. [healthdocbox.com]
The objective of this study was to determine the epidemiological, histological, and immunohistochemical characteristics of medullary carcinoma and to analyze whether differences exist between sporadic and familial carcinomas. [elsevier.es]
Center for Epidemiology. Cancer Incidence in Sweden 1996. Stockholm, 1998. Google Scholar 17. Goldgar DE, Easton DF, Cannon-Albright LA, Skolnick MH. Systematic population-based assessment of cancer risk in first-degree relatives of cancer probands. [link.springer.com]
Epidemiology Frequency United States Medullary carcinoma of the thyroid (MTC) constitutes approximately 4% of all thyroid cancers in the United States. [2] This figure translates into approximately 1000 diagnoses per year. [reference.medscape.com]
Epidemiology of thoracic aortic dissection. Nat Rev Cardiol. 2011;8(2):103–13. 6. Knepper J, Upchurch Jr GR. A review of clinical trials and registries in descending thoracic aortic aneurysms. Semin Vasc Surg. 2010;23(3):170–5. 7. [cardiothoracicsurgery.biomedcentral.com]
Pathophysiology
Pathophysiology Medullary thyroid cancer (MTC) is usually diagnosed on physical examination as a solitary neck nodule, and early spread to regional lymph nodes is common. Distant metastases occur in the liver, lung, bone, and brain. [reference.medscape.com]
Markers of the extension of atherosclerosis, such as the presence of atheromatous plaques in the thoracic aorta, have been associated with a higher prevalence of AAA (14% vs 1.4%).19 Pathophysiology The factors that trigger a response in the form of a [revespcardiol.org]
Familial thoracic aortic aneurysm/dissection with patent ductus arteriosus: genetic arguments for a particular pathophysiological entity. Eur J Hum Genet. 2004;12:173–80. [ncbi.nlm.nih.gov]
Prevention
CONCLUSION: It appears that preventive lymphadenectomy does not substantially improve survival, while pre-clinical diagnosis is of greater importance than surgery in improving survival and preventing recurrence. [ncbi.nlm.nih.gov]