98.2.23-Discussion Presentation

• What is diagnostic W/U for patients with persistent biochemical      MTC?
• What is possibility bone metastasis in MTC?
•  What is physiopathology of diarrhea in patients with MTC?
•  What is prognosis in this case ?
•  What should be do in the case?

• What is diagnostic W/U for patients with persistent biochemical      MTC?
• What is possibility bone metastasis in MTC?
• Whatis physiopathology of diarrhea in patients with MTC?
•  What is prognosis in this case ?
•  What should be do in the case?
• Total thyroidectomy + L.N compartment level VI dissection
• When preoperative imaging is positive in the ipsilateral lateral neck compartment but negative in the contralateral neck compartment, contralateral neck dissection should be considered if the basal serum calcitonin level is greater than 200 pg/mL. Grade C

In MTC patients with extensive neck disease and signs or symptoms of regional or distant metastases, and in all patients with a serum Ctn > 500 pg/ml (preoperative) or > 150 pg/ml (postoperative)

• Contrast-enhanced CT of the neck and chest
• Three-phase contrast-enhanced multi-detector liver CT, or contrast-enhanced MRI of the liver
•  bone scintigraphy
•  pelvic MRI
• Axial skleton MRI.  (Grade C)
•  FDG-PET/CT nor F-DOPA-PET/CT is recommended to detect the presence of distant metastases (Grade E)