Medullary thyroid microcarcinoma recommendations for treatment - A single-center experience

The biochemical discrimination cannot be made between patients with CCH and MTC, and patients with MTC with/without LN metastasis. Thus, thyroidectomy and central neck dissection is indicated in patients with “mildly” elevated sCT levels (<560pg/ml) (LN positive: 1 of 37 patients [2.7%]). A lateral neck dissection may be added “on demand” (in the setting of measurable postoperative bCT and/or sCT levels indicating LN metastasis). Patients with “highly” elevated sCT (≥560pg/ml) must be treated as “palpable” MTC (LN positive: 10 of 54 patients [18.5%]).