[The routine immunohistochemical diagnosis and surgical treatment of medullary carcinoma of the thyroid].

Over the period 1977 through 1988, in the Research Institute of Surgery--Medical Academy a total of 372 patients undergo primary operative management for thyroid gland carcinoma. Medullary carcinoma is discovered in 18 patients of the series (4.8 per cent). The preoperative diagnosis is supplemented by thyroscintigraphy with 131iodine or technetium Tc 201. After 1981, calcitonin and carcinoembryonic antigen (CEA), specific medullary thyroid carcinoma (MTC) markers, measurements are routinely done, with substantially elevated levels in the patients under study being found, in those with metastases inclusive. Presumably, the preoperative diagnosis medullary thyroid carcinoma is very difficult, and only a combined approach, including thyroidectomy with ensuing iodine radiotherapy, may account for a good survivorship. Postoperatively, all patients with MTC diagnosis are regularly tested for serum calcitonin and CEA levels. The carefully taken family history and questioning of the patients allows to differentiate familial from cases from sporadic neoplasms.