Medullary thyroid carcinoma: surgical treatment advances

PURPOSE OF REVIEW: In recent years new technologies have been proposed and applied in thyroid surgery, among these molecular diagnosis and endoscopic procedures. The authors review relevant medical literature published on the influence of these new techniques in the treatment of medullary thyroid cancer. Searches were last updated in October 2007. RECENT FINDINGS: Mutations of the RET proto-oncogene have been demonstrated to be causative of the familial form of medullary thyroid cancer. The number and type of recognized RET genetic mutations have grown over the last years, especially after the introduction of genetic screening in the work-up of all patients with medullary thyroid cancer. Prophylactic surgery for patients carrying a positive RET proto-oncogene is highly effective. Cervical endoscopic procedures have been recently described and applied for positive RET carriers: a video-assisted thyroidectomy with central compartment dissection (level 6) has proved feasible, safe and effective for these patients. SUMMARY: There have been some important papers in the recent literature that apply to many aspects of new technologies for medullary thyroid cancer treatment. This article discusses some of these articles, emphasizing where this literature makes new contributions and supports established recommendations.

PURPOSE OF REVIEW: In recent years new technologies have been proposed and applied in thyroid surgery, among these molecular diagnosis and endoscopic procedures. The authors review relevant medical literature published on the influence of these new techniques in the treatment of medullary thyroid cancer. Searches were last updated in October 2007. RECENT FINDINGS: Mutations of the RET proto-oncogene have been demonstrated to be causative of the familial form of medullary thyroid cancer. The number and type of recognized RET genetic mutations have grown over the last years, especially after the introduction of genetic screening in the work-up of all patients with medullary thyroid cancer. Prophylactic surgery for patients carrying a positive RET proto-oncogene is highly effective. Cervical endoscopic procedures have been recently described and applied for positive RET carriers: a video-assisted thyroidectomy with central compartment dissection (level 6) has proved feasible, safe and effective for these patients. SUMMARY: There have been some important papers in the recent literature that apply to many aspects of new technologies for medullary thyroid cancer treatment. This article discusses some of these articles, emphasizing where this literature makes new contributions and supports established recommendations. © 2008 Lippincott Williams & Wilkins, Inc.