Medullary Thyroid Carcinoma: An Update on Imaging

Abstract

Medullary thyroid carcinoma (MTC), arising from the parafollicular C cells of the thyroid, accounts for 1–2% of thyroid cancers. MTC is frequently aggressive and metastasizes to cervical and mediastinal lymph nodes, lungs, liver, and bones. Although a number of new imaging modalities for directing the management of oncologic patients evolved over the last two decades, the clinical application of these novel techniques is limited in MTC. In this article, we review the biology and molecular aspects of MTC as an important background for the use of current imaging modalities and approaches for this tumor. We discuss the modern and currently available imaging techniques—advanced magnetic resonance imaging (MRI)-based techniques such as whole-body MRI, dynamic contrast-enhanced (DCE) technique, diffusion-weighted imaging (DWI), positron emission tomography/computed tomography (PET/CT) with 18F-FDOPA and 18F-FDG, and integrated positron emission tomography/magnetic resonance (PET/MR) hybrid imaging—for primary as well as metastatic MTC tumor, including its metastatic spread to lymph nodes and the most common sites of distant metastases: lungs, liver, and bones.

miR‑592 acts as an oncogene and promotes medullary thyroid cancer tumorigenesis by targeting cyclin‑dependent kinase 8

“…Thyroid cancer can be divided into multiple subtypes, the majority of which originate from follicular cells. Medullary thyroid cancer (MTC), which accounts for 5–10% of all cases of thyroid cancer, is the only type that originates from parafollicular C cells ( 2 , 3 ). Patients with MTC with an obvious thyroid nodule frequently present with cervical metastases and ~13% present with distant metastases ( 4 , 5 ).…”

Medullary Thyroid Carcinoma Presenting as Metastatic Disease to the Breast

“…Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor that accounts for 1-4% of all thyroid cancers in the United States [2][3][4]. It originates from parafollicular (C cells) of the thyroid and its pattern of spread is predominantly lymphovascular.…”

“…It originates from parafollicular (C cells) of the thyroid and its pattern of spread is predominantly lymphovascular. Metastasis occurs early to local lymph nodes such as the paratracheal and lateral cervical lymph nodes [3,5] via lymphatics. Spread outside the neck occurs later in the course of the disease, via venous invasion, commonly to the liver, lungs, and bones with less frequent spread to the skin and brain [3].…”

PET en el diagnóstico de la patología de tiroides

“…Actualmente no existe un consenso claro de cara al uso de las técnicas de imagen para su valoración. La PET/TC tiene su principal indicación en la detección de recurrencias tumorales y metástasis, existiendo para ello varios tipos de radiofármacos PET que se resumen a continuación [7]. Síndrome TENIS: Paciente con diagnóstico de carcinoma folicular de tiroides, variante oncocítica de alto riesgo.…”