J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 10839KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 82(5): 441-455, 1981

Original article

CLINICAL AND HISTOPATHOLOGICAL STUDIES ON MEDULLARY CARCINOMA OF THE THYROID
―WITH SPECIAL REFERENCE TO THE DIFFERENCES BETWEEN SPORADIC GROUP AND FAMILIAL GROUP OF MEDULLARY CARCINOMA―

1) The First Department of Surgery, Nagoya University School of Medicine
2) The Hukkei's Surgery, Nagoya Hoken-Eisei University School of Medicine

Eiske Tame1), Kiyomi Sahashi1), Katsuhiko Akao1), Mitsunobu Maeda1), Uji Nimura1), Tatsuo Hattori1), Yohotaro lyomasa1), Akihiro Yamaguchi2), Kahoru Miura2)

It is said that a great difference exists in their biological characteristics between the sporadic group and the familial group of medullary carcinoma. However, a sufficient clarification has not been made yet on this matter from clinical and histopathological standpoints. Thus, in this study 6 cases of sporadic group and 4 cases of familial group of medullary carcinoma were taken up for clinical, histopathological and electronmicroscopic studies (especially as to secretory granules), while 7 cases were employed for the immunohistochemical study by using anticalcitonin.
The results as follows.
1) In the sporadic group, medullary carcinoma arose unilaterally. Even upon lobectomy or incomplete operation some cases showed a favorable prognosis, while on the other hand some had recurrences soon after the radical operation. Except for the cases with a favorable prognosis, tumor cells in the sporadic group were mainly atypical. The capsule was incomplete or absent. In many cases infiltration of tumor cells into neighboring tissue of thyroid was observed with strong vascular invasion. There seemed to be less amyloid and calcification, and lymphonode metastasis was severe and frequent.
2) In familial group, medullary carcinoma arose on both sides multicentrically. When total thyroidectomy was carried out, an early postoperative recurrence was not observed, and the prognosis were favorable. Tumor cells consisted of typical cells whose histological picture showed a lot of variety. Besides, the other histological findings were generally contrary to those of the sporadic group. In addition, in neighboring thyroid, hyoerplasia of parafollicular cells was observed.
3) Accordingly the familial group is considered to be of less malignant tumor based on hyperplasia of parafollicular cells.
4) The number of secretory granule was large in the familial group and small in the sporadic group, but in the sporadic cases with favorable prognosis it was comparatively large. There-fore the number of secretory granule seems to be related to the grade of malignancy of the tumor.

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