Medullary thyroid carcinoma: evaluating the performance of diagnostic tests

Abstract

INTRODUCTION Thyroid nodules are a frequent finding, with reported prevalence of 33-68% among adults [1,2]. These nodules can be malignant and fine-needle aspiration (FNA) is the most effective diagnostic test to determine malignancy or the need for surgery to reach such conclusion [3]. However, most of thyroid nodules are benign, with only a small percentage of thyroid nodules being malignant [4]. Therefore, it is not optimal to perform FNA in every case. Thyroid ultrasound (US) plays an important part in stratifying the risk of malignancy and deciding whether FNA is necessary or observation is sufficient. When suspecting malignancy papillary thyroid carcinoma first comes to mind because it is the most common type of thyroid cancer [5]. Medullary thyroid carcinoma is more aggresive and more likely to metastasize [6,7]. However, it is also less common, ranking third in terms of frequency of thyroid cancer [8,9]. Treatment of medullary thyroid carcinoma is complex and prognosis is usually poor if the cancer has metastasized [10,11]. The aim of this study is to analyse sonographic, cytologic and histologic properties of medullary thyroid carcinoma.