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Head and Neck Imaging

Medullary carcinoma, thyroid

malignant thyroid tumour, originating from the parafollicular calcitonin secreting 'C-cells'. It occurs as a sporadic malignancy, or as familial cases in multiple endocrine neoplasia (MEN) syndromes; in MEN IIA (Sipple's syndrome), it is associated with phaeochromocytoma and parathyroid adenomas or hyperplasia; in MEN IIB, medullary carcinoma is associated with mucosal neuromas, other mucocutaneous features and marphanoid facies.

In sporadic cases, medullary carcinoma is usually unilateral, but in familial cases it is often present bilaterally in the thyroid gland. Lymphatic spread is present in 5075% of cases, and involvement of mediastinal lymph nodes is frequent. Distant metastasis is seen most often in the liver, lungs and bones.

The imaging findings of the primary tumour are nonspecific (see also thyroid gland). The neck adenopathies have been reported to show strong contrast enhancement and may contain calcifications.