Diagnostic and Therapeutic Insights of Medullary Thyroid Cancer With Epicenter at the Isthmus and Pyramidal Lobe in an Adult Male

Abstract

Medullary thyroid carcinoma (MTC) is uncommon, accounting for around 5% of all thyroid malignancies, with 75% arising sporadically, and 25% linked to multiple endocrine neoplasia type 2 (MEN2). It develops from parafollicular C cells, which secrete calcitonin, a diagnostic and prognostic marker. Genetic variations are important, particularly those in the RET (rearranged during transfection) proto-oncogene. In the present case, a 58-year-old man came with central neck swelling. Investigations indicated that the MTC had an epicenter in the thyroid isthmus and spread across both lobes. MTC predominantly originating from the central part of thyroid is rare. The patient underwent total thyroidectomy with bilateral neck dissection and adjuvant radiotherapy. Early identification using calcitonin levels and imaging, along with surgical and adjuvant care, is critical for successful management and reduction of recurrence risk.