Slide of the Week: Medullary Thyroid Cancer, September 5th, 2011

Medullary Thyroid Cancer: A 28 year old male has suffered from FUO, high blood pressure, diarrhea, and rapid heart rate for several years.  Examination revealed enlarged cervical lymph nodes and thyroid nodularity.  A biopsy was taken, as were several blood tests.  After determining he carried a specific genetic mutation he was diagnosed with Sipple Syndrome (MEN 11-B).

Medullary Thyroid Cancer


A mutation in what gene was found?

  1. RET
  2. STAT 1
  3. BCR/ABL




Click here to see the whole slide image.

Click here for the comparative pathology.

Scroll below for answers.










Answer: 1, RET.



The cause of most medullary thyroid carcinoma cases is unknown. However, some are associated with MEN (multiple endocrine neoplasia).  One of these diseases is Sipple Syndrome (MEN 11-B).  It is an autosomal dominant inherited syndrome that includes bilateral C cell (medullary) carcinoma, pheochromocytoma and hyperthyroidism.  Both males and females carrying this gene usually become symptomatic in their thirties.  The cancer cell of origin is the C cell which is the producer of calcitonin.



Randolph, GW and D Maniar. Medullary Carcinoma of the Thyroid. Cancer Control 2000, 7:253-261

Zhou Z, Flesken-Nikitin A, Levine CG, Shmidt EN, Eng JP, Nikitina EY, Spencer DM, Nikitin AY. Suppression of melanotroph carcinogenesis leads to accelerated progression of pituitary anterior lobe tumors and medullary thyroid carcinomas in Rb+/- mice. Cancer Res. 2005 Feb 1;65(3):787-96. PubMed PMID: 15705875.

Matoso A, Zhou Z, Hayama R, Flesken-Nikitin A, Nikitin AY. Cell lineage-specific interactions between Men1 and Rb in neuroendocrine neoplasia. Carcinogenesis. 2008 Mar;29(3):620-8. Epub 2007 Sep 24. PubMed PMID: 17893233.




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