Thursday, March 01, 2007
I saw a 50 Y/O male for second opinion with a Biopsy proven DX of Medullary Thyroid Carcinoma MCT. He had prior FNA of a 2 cm left lobe nodule. The cells and staining for calcitonin on the slides confirmed MCT. What do I need to do to help him. First, I did an ultrasound of 1-6 levels lymph nodes on both sides of the neck. He had many abnormal shaped nodes. Because the nodule was on the left, and his RET DNA did not show family MCT, the surgeon was only going to do the lymph nodes on that side of the nodule. I called the surgeon, and informed him that there were nodes on Both sides, and if he hoped to give him the best chance for cure he needed to do complete lymph node removal on the right, left, and central compartment. He agreed to do this extensive surgery to try to cure him. There were cancer nodes on both sides of the neck. He took out everything, and sent him back to me on thyroid hormone to see what the MCT cancer marker, Calcitonin was after complete bilateral neck disection. He is recovering well without major side effects. Stay turned for a post surgery follow tests in 4 weeks.