Advanced medullary thyroid carcinoma
a challenge for multimodal treatment (case presentation)
Abstract (Eng)Medullary thyroid cancer is a rare, neuroendocrine, tumor. It arises from parafollicular or C-cells with the ability to produce and secrete different bioactive substances like calcitonin (TC) and CEA. MTC occurs as a sporadic tumor or in hereditary settings MEN 2A, MEN 2B and FMCT. Germ line point mutations in RET proto-oncogene are responsible for tumor rise and inheritance of settings. RET mutations diagnostics in MTC patients and their first degree relatives form the basis of genetic screening.
Biological behavior of MTC shows great clinical variability. Surgery is still the treatment of choice for MTC while teleradiotherapy, chemotherapy and radioimmunotherapy are indicated in advanced disease. Molecularly targeted treatments are now part of clinical studies with some promising results. Status at admission is still the most important prognostic factor. Diagnostics, treatment - including molecularly targeted treatment and follow-up of 29-years-old patient with respiratory distress due to the advanced MTC is represented. In this case, inhibitors of receptor tyrosine kinases were used for the first time as a part of multimodal treatment of MTC at the Institute of Oncology (OI).
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