Der Klinikarzt 2012; 41(10): 476-480
DOI: 10.1055/s-0032-1330949
Schwerpunkt
© Georg Thieme Verlag Stuttgart · New York

Medulläres Schilddrüsenkarzinom – Besonderheiten, Diagnostik, Therapie und Nachsorge

Medullary thyroid carcinoma – Characteristics, diagnostics, therapy and follow-up
Oliver Gimm
1   Department of Surgery, University Hospital, Linköping, Schweden
› Author Affiliations
Further Information

Publication History

Publication Date:
07 November 2012 (online)

Das medulläre Schilddrüsenkarzinom (MTC) ist ein seltener maligner Tumor der Schilddrüse, es macht vermutlich ca. 3–8 % aller Schilddrüsenkarzinome aus. Im Gegensatz zu dem Großteil der Schilddrüsenkarzinome, welche von den Thyreozyten ausgehen, hat das MTC seinen Ursprung in den parafollikulären C-Zellen. Diese synthetisieren u.a. Kalzitonin, das als sehr sensitiver Tumormarker gilt. Das MTC ist der sonst postoperativ üblichen konventionellen Radiojodtherapie nicht zugänglich, weil die C-Zellen im Gegensatz zu den Thyreozyten kein Jod aufnehmen. Dies stellt zusätzliche Anforderungen an die chirurgische Therapie. Gegenstand aktuell intensiver Forschung gilt der Behandlung von MTCs, welche auf Grund von Inoperabilität bzw. dem Vorhandensein von disseminierten Fernmetastasen einer chirurgischen Therapie nicht zugänglich sind.

Medullary thyroid carcinoma (MTC) is a rare malignant tumor of the thyroid gland, it probably accounts for about 3 – 8 % of all thyroids cancers. In contrast to the majority of thyroid cancers that develop from thyreocytes, MTC has its origins in parafollicular C cells. Among others, these cells synthesize calcitonin which thus represents a very sensitive tumor marker. MTC is not responsive to the usually employed conventional radio-iodine therapy because C cells, in contrast to threocytes, do not take up iodine. This fact places additional demands on surgical treatment. The management of MTCs that are not suitable for operative treatment because of their inoperable nature or, respectively, due to the presence of distant disseminated metastases is a hot topic of current intensive research

 
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