[Our experience in the study and treatment of medullary carcinomas of the thyroid. Apropos of 2 familial cases].

Between July 1976 and July 1984, 1106 cold thyroid nodules have been operated on UCL. Teaching Hospital; 128 were diagnosed as carcinoma (11,5%) and 15 were diagnosed as medullary carcinoma of the thyroid gland (1,3% of all the cold nodules and 12% of all carcinomas of the thyroid). This article presents the case of two families exhibiting a characteristic clinical history of Medullary Carcinoma of the thyroid or CMT. The authors describe briefly the clinical signs; they point out that it is absolutely necessary to ask for a blood calcitonine level control in case of cold thyroid nodule or cervical lymphadenopathie. Once the diagnosis of Medullary Carcinoma of the thyroid gland is reached, screening of the Family, at least the first degree relatives should be undertaken, in order to reveal subclinical cases, which could be detected by laboratory investigations at an early subclinical stage. The treatment of the CMT is always surgery; it consists of total thyroidectomy with a modified neck dissection or a radical neck dissection, if lymph nodes are more than 3 cm or are fixed. Any way the recurrent nerve nodes have to be looked for, and if positive a Mediastinal lymph node dissection should be carried out. A control of the calcitonine hormone blood level should be asked for twice a year to detect any metastases or recurrence.