Hollenberg C H
Arch Otolaryngol. 1983 Feb;109(2):103-5. doi: 10.1001/archotol.1983.00800160037009.
Medullary cancer of the thyroid is rare but of unusual biologic interest. It originates in the thyroid parafollicular or C cells that are of neural crest origin and that secrete calcitonin. Calcitonin measurements, particularly after pentagastrim administration, are useful in detecting the tumor and following its progression. Ninety percent of medullary cancers are sporadic and 10% are familial; the latter may be associated with pheochromocytoma and parathyroid hyperplasia-adenoma. Initial symptoms of both the sporadic and familial varieties include thyroid mass, diarrhea, and less often, flushing. Uninvolved members of kindreds with the disease should be followed up by repeated measurements of calcitonin after pentagastrim and calcium infusion and should be treated when a positive test result is obtained. Therapy involves total thyroidectomy plus node dissection if indicated. In addition, postoperative radiation may reduce the recurrence rate.
甲状腺髓样癌罕见，但具有特殊的生物学意义。它起源于甲状腺滤泡旁细胞或C细胞，这些细胞起源于神经嵴，可分泌降钙素。降钙素检测，尤其是在给予五肽胃泌素后进行检测，对于检测肿瘤及其进展情况很有用。90%的髓样癌是散发性的，10%是家族性的；后者可能与嗜铬细胞瘤和甲状旁腺增生-腺瘤有关。散发性和家族性类型的初始症状包括甲状腺肿块、腹泻，较少见的有面部潮红。患有该病的家族中未患病成员应在给予五肽胃泌素和静脉输注钙后重复检测降钙素，并在检测结果呈阳性时进行治疗。治疗方法包括全甲状腺切除术，如有指征还需进行淋巴结清扫。此外，术后放疗可能会降低复发率。
