Medullary Thyroid Cancer: It is a pain in the neck?

Guerrero, Marlon A.; Lindsay, Sheila; Suh, Insoo; Vriens, Menno R.; Khanafshar, Elham; Shen, Wen T.; Gosnell, Jessica; Kebebew, Electron; Duh, Quan-Yang; Clark, Orlo H.

doi:10.7150/jca.2.200



International Journal of Biological Sciences

International Journal of Medical Sciences

Theranostics

Journal of Genomics

Nanotheranostics

Global reach, higher impact

Full Text | PDF

J Cancer 2011; 2:200-205. doi:10.7150/jca.2.200 This volume Cite

Research Paper

Medullary Thyroid Cancer: It is a pain in the neck?

Marlon A. Guerrero^1✉, Sheila Lindsay², Insoo Suh², Menno R. Vriens², Elham Khanafshar³, Wen T. Shen², Jessica Gosnell², Electron Kebebew⁴, Quan-Yang Duh², Orlo H. Clark²

1. Department of Surgery, University of Arizona, Tucson, AZ, USA;
2. Department of Surgery, University of California, San Francisco, CA, USA;
3. Department of Pathology, University of California, San Francisco, CA, USA;
4. Surgery Branch, National Cancer Institute, Bethesda, MD, USA

Citation:

Guerrero MA, Lindsay S, Suh I, Vriens MR, Khanafshar E, Shen WT, Gosnell J, Kebebew E, Duh QY, Clark OH. Medullary Thyroid Cancer: It is a pain in the neck?. J Cancer 2011; 2:200-205. doi:10.7150/jca.2.200. https://www.jcancer.org/v02p0200.htm

Other styles

Abstract

Background: Medullary thyroid cancer (MTC) commonly presents with lymph node (LN) metastases, and has a worse prognosis than papillary thyroid cancer (PTC). Tumor size and LN involvement have been shown to affect stage of disease; however, to our knowledge, ours is the first study that attempts to correlate anterior neck pain on presentation with the extent of disease.

Methods: We performed a retrospective review of patients with MTC who underwent an operation from February 1998 through December 2008. We compared the symptom of anterior neck pain with the pathologic extent of disease. Our control group comprised patients who underwent an operation for PTC. Analysis was performed using the Fisher's exact test and the Mann-Whitney test.

Results: Of the 109 patients with MTC, 50 (46%) met our inclusion criteria. Of the 50 patients with MTC, 11 presented with neck pain, compared to 3 of the 50 patients with PTC (p = 0.041). Of those 11 patients, 9 (82%) had LN involvement on final pathology, as compared with 14 (36%) of the 39 without neck pain (p = 0.014). Of patients with neck pain, 18% were diagnosed at stage I to II and 82% at stage III to IV, compared to 64% at stage I to II and 36% at stage III to IV (p = 0.014).

Conclusions: Our study demonstrates that more patients with MTC present with anterior neck pain than do patients with PTC and that patients with MTC and neck pain have an increased risk of LN metastases. The results of this study suggest that MTC patients, who present with concomitant neck pain, should undergo a total thyroidectomy, prophylactic bilateral central neck dissection, and ipsilateral lateral neck dissection.

Keywords: Medullary thyroid cancer, lymph node, papillary thyroid cancer

Citation styles

APA

Guerrero, M.A., Lindsay, S., Suh, I., Vriens, M.R., Khanafshar, E., Shen, W.T., Gosnell, J., Kebebew, E., Duh, Q.Y., Clark, O.H. (2011). Medullary Thyroid Cancer: It is a pain in the neck?. Journal of Cancer, 2, 200-205. https://doi.org/10.7150/jca.2.200.

ACS

Guerrero, M.A.; Lindsay, S.; Suh, I.; Vriens, M.R.; Khanafshar, E.; Shen, W.T.; Gosnell, J.; Kebebew, E.; Duh, Q.Y.; Clark, O.H. Medullary Thyroid Cancer: It is a pain in the neck?. J. Cancer 2011, 2, 200-205. DOI: 10.7150/jca.2.200.

NLM

CSE

Guerrero MA, Lindsay S, Suh I, Vriens MR, Khanafshar E, Shen WT, Gosnell J, Kebebew E, Duh QY, Clark OH. 2011. Medullary Thyroid Cancer: It is a pain in the neck?. J Cancer. 2:200-205.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See http://ivyspring.com/terms for full terms and conditions.