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Review
. 2015 Jun;25(6):567-610.
doi: 10.1089/thy.2014.0335.

Revised American Thyroid Association Guidelines for the Management of Medullary Thyroid Carcinoma

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Free PMC article
Review

Revised American Thyroid Association Guidelines for the Management of Medullary Thyroid Carcinoma

Samuel A Wells Jr et al. Thyroid. .
Free PMC article

Abstract

Introduction: The American Thyroid Association appointed a Task Force of experts to revise the original Medullary Thyroid Carcinoma: Management Guidelines of the American Thyroid Association.

Methods: The Task Force identified relevant articles using a systematic PubMed search, supplemented with additional published materials, and then created evidence-based recommendations, which were set in categories using criteria adapted from the United States Preventive Services Task Force Agency for Healthcare Research and Quality. The original guidelines provided abundant source material and an excellent organizational structure that served as the basis for the current revised document.

Results: The revised guidelines are focused primarily on the diagnosis and treatment of patients with sporadic medullary thyroid carcinoma (MTC) and hereditary MTC.

Conclusions: The Task Force developed 67 evidence-based recommendations to assist clinicians in the care of patients with MTC. The Task Force considers the recommendations to represent current, rational, and optimal medical practice.

Figures

<b>FIG. 1.</b>
FIG. 1.
Management of patients with a thyroid nodule and histological diagnosis of medullary thyroid carcinoma. ADX, adrenalectomy; Ctn, calcitonin; CEA, carcinoembryonic antigen; EBRT, external beam radiotherapy; FNA, fine-needle aspiration; HPTH, hyperparathyroidism; LND, lymph node dissection; MTC, medullary thyroid carcinoma; M, metastatic MTC; PHEO, pheochromocytoma; RET, REarranged during Transfection; TKI, tyrosine kinase inhibitor; TTX, total thyroidectomy; US, ultrasound.
<b>FIG. 2.</b>
FIG. 2.
Management of patients with a RET germline mutation detected on genetic screening. ATA, American Thyroid Association risk categories for aggressive medullary thyroid carcinoma (MTC) (HST, highest risk, H, high risk, MOD, moderate risk); Ctn, calcitonin; CEA, carcinoembryonic antigen; HPTH, hyperparathyroidism; PHEO, pheochromocytoma; RET, REarranged during Transfection; TTX, total thyroidectomy; US, ultrasound.
<b>FIG. 3.</b>
FIG. 3.
Management of patients following thyroidectomy for persistent or recurrent medullary thyroid carcinoma. Ctn, calcitonin; CEA, carcinoembryonic antigen; EBRT, external beam radiotherapy; MTC, medullary thyroid carcinoma; TFTs, thyroid function tests; TSH, thyrotropin; TKI, tyrosine kinase inhibitor; TTX, total thyroidectomy; US, ultrasound.

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