Endocrine Abstracts

Introduction: Medullary thyroid carcinoma (MTC) is a rare and silent endocrine tumor representing 5-10% of thyroid cancers. It is the most aggressive form of thyroid carcinoma, usually diagnosed at advanced stages.

Purpose of study: Study the phenotypic and genotypic profiles as well as the anatomical-histological characteristics related to the recurrence of the disease.

Matherials and methods: Descriptive cross-sectional study including patients followed for CMT in the Endocrinology and Diabetology Department of the Ibn ROCHD University Hospital of Casablanca from 2007 to 2021. The statistical analysis was performed by the software SPSS version 25.0.

Results: The study included 24 patients followed up for CMT, the mean age was 47.6 ± 14.35 years, the majority were women (70.8%), a family history of thyroid carcinoma was found in two patients, clinically the thyroid nodule was the reason for consultation in thirteen patients (54. 2%), all patients underwent total thyroidectomy, lymph node dissection was performed in eighteen patients, CMT was in the context of MEN2 in six patients (25%), the genetic study of RET proto-oncogene mutations was positive in three patients. Fourteen patients had metastatic disease (58.3%). Lymph nodes were the most frequent metastatic site. Calcitonin levels at diagnosis were> 500 pg/ml in 57.1% of patients. Most of them had undergone an incomplete first thyroid surgery. In addition, the tumors were larger, multifocal (P<0.05) and with capsular invasion (P<0.02). Of these patients three received chemotherapy, radiotherapy was performed in two patients, and two patients were scheduled for treatment with Sorafenib.

Conclusion: The prognosis of CMT is more pejorative than papillary thyroid carcinoma, several factors were correlated with the development of metastasis, which requires adequate management with close monitoring of the disease.