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A Case-Based Guide to Clinical EndocrinologyMedullary Thyroid Cancer

A Case-Based Guide to Clinical Endocrinology: Medullary Thyroid Cancer Chapter 13 Jacqueline Jonklaas Objectives 1. To understand the presentation and diagnosis of medullary thyroid cancer (MTC) 2. To understand the differences in the presentation and diagnosis of sporadic ver- sus familial MTC 3. To understand the relationship between the presence of a ret proto-oncogene mutation and the development of MTC 4. To understand the relationship between ret proto-oncogene mutations and their associated phenotype 5. To understand the pivotal role of screening and prophylactic thyroidectomy in the management of familial MTC 6. To understand the treatment options for MTC Case Presentation A 45-year-old woman was found by her primary care physician to have a 1.5-cm thyroid nodule. A serum calcitonin level was ordered and found to be elevated at 15 pg/mL (normal <6pg/mL). A fine-needle aspiration revealed a very cellular specimen. The cells were pleomorphic and poorly cohesive. The cells seen included small cells with a granular cytoplasm, large atypical cells, and spindle cells. Binucle- ated cells and cells with eccentric nuclei were also seen. The cytology reading stated that a neoplastic process was suspected. The patient was referred for thyroidectomy. The cytology specimen was not stained for calcitonin or amyloid before the patient’s surgery. A preoperative neck ultrasound http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png

A Case-Based Guide to Clinical EndocrinologyMedullary Thyroid Cancer

Part of the Contemporary Endocrinology™ Book Series
Editors: Davies, Terry F.
Jonklaas, Jacqueline
A Case-Based Guide to Clinical Endocrinology — Jan 1, 2008
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Publisher
Humana Press
Copyright
© Humana Press,Totowa, NJ 2008
ISBN
978-1-58829-815-7
Pages
127 –137
DOI
10.1007/978-1-60327-103-5_13
Publisher site
See Chapter on Publisher Site

Abstract

Chapter 13 Jacqueline Jonklaas Objectives 1. To understand the presentation and diagnosis of medullary thyroid cancer (MTC) 2. To understand the differences in the presentation and diagnosis of sporadic ver- sus familial MTC 3. To understand the relationship between the presence of a ret proto-oncogene mutation and the development of MTC 4. To understand the relationship between ret proto-oncogene mutations and their associated phenotype 5. To understand the pivotal role of screening and prophylactic thyroidectomy in the management of familial MTC 6. To understand the treatment options for MTC Case Presentation A 45-year-old woman was found by her primary care physician to have a 1.5-cm thyroid nodule. A serum calcitonin level was ordered and found to be elevated at 15 pg/mL (normal <6pg/mL). A fine-needle aspiration revealed a very cellular specimen. The cells were pleomorphic and poorly cohesive. The cells seen included small cells with a granular cytoplasm, large atypical cells, and spindle cells. Binucle- ated cells and cells with eccentric nuclei were also seen. The cytology reading stated that a neoplastic process was suspected. The patient was referred for thyroidectomy. The cytology specimen was not stained for calcitonin or amyloid before the patient’s surgery. A preoperative neck ultrasound

Published: Jan 1, 2008

Keywords: Thyroid Cancer; Thyroid Nodule; Medullary Thyroid Carcinoma; Medullary Thyroid; Medullary Thyroid Cancer

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