Introduction:
Medullary thyroid carcinoma Most patients in the first visit, the main manifestation is the painless hard solid nodules of the thyroid.
Cause:
Chinese medicine believes that this disease is mainly caused by emotional anger, ignorance and lack of righteousness, resulting in turbidity, dampness, blood stasis and evil fire in the neck.
an examination:
Clinical manifestations: Most patients in the first visit, the main performance is the painless hard solid nodules of the thyroid, local lymphadenopathy, sometimes lymph node enlargement becomes the first symptom, such as with heterologous ACTH, can produce different symptoms, serum Calcitonin levels are significantly increased, which is the biggest feature of the disease, so calcitonin becomes a diagnostic marker, more than 0.6ng / ml, should consider C cell proliferation or medullary carcinoma, due to calcitonin on blood calcium The level of regulation is far less powerful than parathyroid hormone, as well as ganglionoma or mucosal neuroma, which is MEN.
At the time of physical examination, the thyroid mass is solid, the boundary is unclear, and the surface is not smooth. The family and MEN2 patients can be bilateral thyroid masses, and the masses have better activity. After the late invasion of adjacent tissues, they are more fixed, such as hoarseness.
diagnosis:
The disease is highly malignant and can be metastasized through the bloodstream. The medullary thyroid carcinoma can be divided into four types.
1 scattered hair: 70% to 80%, non-genetic, no similar diseases in the family, will not be passed on to the offspring, no other endocrine gland lesions, the ratio of male to female incidence is about 2:3, and there is Codon mutations have a poor prognosis.
2 Familial type: refers to patients with a family genetic predisposition, but not accompanied by other endocrine glands, the age of high incidence is 40 to 50 years old. Its gene mutation pattern is the same as MEN2A.
3MEN2A: MEN is multiple endocrine neoplasia syndrome (MEN), which is related to medullary thyroid carcinoma is MEN2A and MEN2B, including bilateral medullary thyroid carcinoma or C cell hyperplasia, so the incidence of men and women is similar, high incidence The age is 30 to 40 years old and involves 609 of exon 10 and 11 of the RET gene.
4MEN2B: including bilateral medullary thyroid carcinoma, and is malignant), but rarely involving the parathyroid glands, the incidence rate of men and women is similar, the high-risk age is 30 to 40 years old. Mutations in the 918th codon in exon 16 of the RET gene were found in almost all cases.
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