Sonographic features of medullary thyroid carcinoma

doi:10.3877/cma.j.issn.1672-6448.2015.10.007

Abstract

Abstract:

Objective

To investigate sonographic features of medullary thyroid carcinoma (MTC).

Methods

Clinical and sonographic features of MTC in 49 pathologically confirmed patients were retrospectively analyzed, 64 pathologically proven papillary thyroid carcinoma (PTC) patients were settled as control group. Sonographic features such as lesion size, shape, echogenicity, calcification, intranodular vascularity and neck lymphadenopathy were compared between MTC and PTC groups.

Results

Both MTC and PTC lesions were often presented as hypoechoic (51/61, 83.6%) with unclear margin (39/61, 63.9%), microcalicifications (33/61, 54.1%) and neck lymphadenopathy (22/49, 44.9%) were noticed in both two groups. Compared with PTC (M=2.20 cm, Q=1.70 cm), the mean size of MTC (M=0.80, Q=0.70 cm) was larger (P<0.001); MTC group presented less ?taller than wide? feature [4/61 (6.6%) vs 45/79 (57.0%), P<0.001]; Complex echogenicity in MTC group were more commonly seen [10/61 (16.4%) vs 2/79 (2.5%), P = 0.003]; More MTC lesions presented increased intranodular vascularity [56/61 (91.8%) vs 31/79 (39.2%), P<0.001].

Conclusion

Sonographic features of MTC and PTC group were similar, however, the statistical difference between two groups were noticed and should be considered in the process of thyroid nodule diagnosis.

Key words: Thyroid neoplasms, Ultrasonography, Doppler, color, Thyroid gland

Meijuan Liu, Yu Xia, Yuxin Jiang, Qing Dai, Yalan Bi, Sheng Cai, Bo Zhang, Meng Yang, Jianchu Li. Sonographic features of medullary thyroid carcinoma[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2015, 12(10): 773-777.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2015.10.007

https://chaosheng.cma-cmc.com.cn/EN/Y2015/V12/I10/773

Figures/Tables 2

References 15

[1]	Roman S, Mehta P, Sosa JA. Medullary thyroid cancer: early detection and novel treatments [J]. Curr Opin Oncol, 2009, 21(1): 5-10.
[2]	Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer [J]. Thyroid, 2009, 19(11): 1167-1214.
[3]	Brandi ML, Gagel RF, Angeli A, et al. Guidelines for diagnosis and therapy of MEN type 1 and type 2 [J]. J Clin Endocrinol Metab, 2001, 86(12): 5658-5671.
[4]	Gimm O, Sutter T, Dralle H. Diagnosis and therapy of sporadic and familia medullary throid carcinoma [J]. Cancer Res Clin Oncol, 2001, 127(3): 156-161.
[5]	Agarwal SK, Mateo CM, Marx SJ. Rare germline mutations in cyclin-dependent kinase inhibitor genes in multiple endocrine neoplasia type 1 and related states [J]. J Clin Endocrinol Metab, 2009, 94(5): 1826-1834.
[6]	Abraham DT, Low TH, Messina M, et al. Medullary thyroid carcinoma: long-term outcomes of surgical treatment [J]. Ann Surg Oncol, 2011, 18(1): 219-225.
[7]	Meier CA. Thyroid nodules: pathogenesis, diagnosis and treatment [J]. Baillieres Best Pract Res Clin Endocrinol Metab, 2000, 14(4): 559-575.
[8]	Hegedüs L, Bonnema SJ, Bennedbaek FN. Management of simple nodular goiter: current status and future perspectives [J]. Endocr Rev, 2003, 24(1): 102-132.
[9]	Woliński K, Rewaj-Łosyk M, Ruchała M. Sonographic features of medullary thyroid carcinomas-a systematic review and meta-analysis [J]. Endokrynol Pol, 2014, 65 (4): 314-318.
[10]	Kim SH, Kim BS, Jung SL, et al. Ultrasonographic findings of medullary thyroid carcinoma: a comparison with papillary thyroid carcinoma[J]. Korean J Radiol, 2009, 10(2): 101-105.
[11]	Lee S, Shin JH, Han BK, et al. Medullary thyroid carcinoma: comparison with papillary thyroid carcinoma and application of current sonographic criteria [J]. Am J Roentgenol, 2010, 194(4): 1090-1094.
[12]	Moon WJ, Jung SL, Lee JH, et al. Benign and malignant thyroid nodules: US differentiation-multicenter retrospective study [J]. Radiology, 2008, 247(3): 762-770.
[13]	Foschini MP, Ragazzi M, Parmeggiani AL, et al. Comparison between Echo-Color Doppler sonography features and angioarchitecture of thyroid nodules [J]. Int J Surg Pathol, 2007, 15(2): 135-142.
[14]	Gimm O. Extent of surgery in clinically evident but operable MTC-when is central and/or lateral lympadenectomy indicated [J]. Thyroid Res, 2013, 6(Suppl 1): S3.
[15]	Wu LM, Gu HY, Qu XH, et al. The accuracy of ultrasonography in the preoperative diagnosis of cervical lymph node metastasis in patients with papillary thyroid carcinoma: A meta-analysis [J]. Eur J Radiol, 2012, 81(8): 1798-1805.

组别	病灶数	大小（cm）	形态		边界形态		病灶回声形态
组别	病灶数	大小（cm）	纵横比>1	纵横比≤1	清	不清	低	中高	混合
MTC	61	2.20，1.7	4（6.6）	57（93.4）	22（36.1）	39（63.9）	51（83.6）	0	10（16.4）
PTC	79	0.80，0.70	45（57.0）	34（43.0）	17（21.5）	62（78.5）	74（93.7）	3（3.8）	2（2.5）
检验值	?	Z=6.80	χ²=38.44		χ²=3.62		-
P值	?	<0.001	<0.001		0.057		0.003
组别	病灶数	钙化形态				血流信号形态			颈部淋巴结形态
组别	病灶数	微小	粗大	周边	未见	丰富	可见	未见	异常	未见异常
MTC	61	33（54.1）	1（1.6）	0	27（44.3）	56（91.8）	3（4.9）	2（3.3）	22/49（44.9）	27/49（55.1）
PTC	79	42（53.2）	5（6.3）	1（1.3）	31（39.2）	31（39.2）	39（49.4）	9（11.4）	21/64（32.8）	43/64（67.2）
检验值	?	-				χ²=40.86			χ²=1.72
P值	?	0.491				<0.001			0.19

组别	病灶数	大小（cm）	形态		边界形态		病灶回声形态
组别	病灶数	大小（cm）	纵横比>1	纵横比≤1	清	不清	低	中高	混合
MTC	61	2.20，1.7	4（6.6）	57（93.4）	22（36.1）	39（63.9）	51（83.6）	0	10（16.4）
PTC	79	0.80，0.70	45（57.0）	34（43.0）	17（21.5）	62（78.5）	74（93.7）	3（3.8）	2（2.5）
检验值	?	Z=6.80	χ²=38.44		χ²=3.62		-
P值	?	<0.001	<0.001		0.057		0.003
组别	病灶数	钙化形态				血流信号形态			颈部淋巴结形态
组别	病灶数	微小	粗大	周边	未见	丰富	可见	未见	异常	未见异常
MTC	61	33（54.1）	1（1.6）	0	27（44.3）	56（91.8）	3（4.9）	2（3.3）	22/49（44.9）	27/49（55.1）
PTC	79	42（53.2）	5（6.3）	1（1.3）	31（39.2）	31（39.2）	39（49.4）	9（11.4）	21/64（32.8）	43/64（67.2）
检验值	?	-				χ²=40.86			χ²=1.72
P值	?	0.491				<0.001			0.19

Please choose a citation manager

Content to export