Recent Updates on the Management of Medullary Thyroid Carcinoma

다국어 초록 (Multilingual Abstract)

Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor derived from the thyroid C cells producing calcitonin. MTC accountsfor 0.6% of all thyroid cancers and incidence of MTC increased steadily between 1997 and 2011 in Korea. It occurs eithersporadically or in a hereditary form based on germline rearranged during transfection (RET) mutations. MTC can be cured only bycomplete resection of the thyroid tumor and any loco-regional metastases. The most appropriate treatment is still less clear in patientswith residual or recurrent disease after initial surgery or those with distant metastases because most patients even with metastaticdisease have indolent courses with slow progression for several years and MTC is not responsive to either radioactive iodinetherapy or thyroid-stimulating hormone suppression. Recently, two tyrosine kinase inhibitors (TKIs), vandetanib and cabozantinib,are approved for use in patients with advanced, metastatic or progressive MTC. In this review, we summarize the current approachaccording to revised American Thyroid Association guidelines and recent advances in systemic treatment such as TKIs for patientswith persistent or recurrent MTC after surgery.

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